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MYTHICAL WELLNESS
NPI 1477362861
Clinic/Center - Primary Care in Prescott, AZ

Active since December 31, 2024CLIA 03D2344422 · Waiver
1000 WILLOW CREEK RD STE C, PRESCOTT, AZ 86301(928) 362-0577(928) 916-5441 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 3, 2025, May 23, 2025, Jan 1, 2025 (3 updates tracked since 2025).

About Mythical Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYTHICAL WELLNESS (NPI 1477362861) is a healthcare organization registered as a primary care in Prescott, Arizona and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists Victoria Angel, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1477362861
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMYTHICAL WELLNESS
Location Address1000 WILLOW CREEK RD STE CPrescott, AZ 86301-1645
Mailing Address1000 Willow Creek Rd Ste CPrescott, AZ 86301-1645 · (928) 362-0577 · Fax (928) 916-5441
Phone(928) 362-0577
Fax(928) 916-5441
Organization SubpartNo
Authorized OfficialVictoria AngelOwner/provider · (928) 362-0577
Enumeration DateDecember 31, 2024
Last NPPES UpdateSeptember 3, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2025
✔ NPI 1477362861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedFamily Medicine · Hospice and Palliative MedicineTaxonomy 207QH0002X
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
1000 WILLOW CREEK RD STE C, Prescott, AZ 86301
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2344422

Mythical Wellness, PLLC · Prescott, AZ
Active · expires May 20, 2028
CLIA Number03D2344422
Laboratory TypePhysician Office
Certificate Effective DateMay 21, 2026
Certificate Expiration DateMay 20, 2028
Laboratory DirectorVictoria M. Angel
Laboratory Phone(928) 362-0577
Laboratory LocationMythical Wellness, PLLC1000 Willow Creek Rd Ste C, Prescott, AZ 86301
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICTORIA MICHELLE ANGEL APRN, FNP-BC
Nurse Practitioner (Primary Care)
1000 WILLOW CREEK RD STE C
PRESCOTT, AZ 86301
Yavapai County (928) 362-0577

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mythical Wellness's NPI number?

The NPI number for Mythical Wellness is 1477362861. It was assigned to this organization in the NPPES registry on December 31, 2024.

Where is Mythical Wellness located?

Mythical Wellness is located at 1000 Willow Creek Rd Ste C, Prescott, AZ 86301. The listed phone number is (928) 362-0577.

What is Mythical Wellness's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Mythical Wellness hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2344422) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mythical Wellness was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.