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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ADVANTAGE PRIMARY HEALTH LLC
NPI 1477496032
Nurse Practitioner - Family in Prescott Valley, AZ

Active since April 09, 2026CLIA 03D2337353 · Waiver
6546 E 2ND ST STE C, PRESCOTT VALLEY, AZ 86314(928) 327-7528(928) 327-7482 Get Directions Write a Review

NPPES record last updated: October 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 15, 2026, May 2, 2026, Apr 17, 2026 and 1 more (4 updates tracked since 2026).

About Advantage Primary Health Llc NPPES

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

ADVANTAGE PRIMARY HEALTH LLC (NPI 1477496032) is a healthcare organization registered as a family in Prescott Valley, Arizona and active in the NPI registry since April 2026. The organization holds a CLIA Waiver certificate valid through January 20, 2028 and lists Desiree Pene, Manager, as its authorized official.

NPPES Registry Identity

NPI1477496032
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameADVANTAGE PRIMARY HEALTH LLC
Location Address6546 E 2ND ST STE CPrescott Valley, AZ 86314-3540
Mailing Address6546 E 2nd St Ste CPrescott Valley, AZ 86314-3540 · (928) 327-7528 · Fax (928) 327-7482
Phone(928) 327-7528
Fax(928) 327-7482
Organization SubpartNo
Authorized OfficialDesiree PeneManager · (928) 800-2295
Enumeration DateApril 9, 2026
Last NPPES UpdateOctober 15, 20264 updates tracked since enumeration
NPPES CertifiedOctober 15, 2026
✔ NPI 1477496032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
6546 E 2ND ST STE C, Prescott Valley, AZ 86314
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advantage Primary Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Advantage Primary Health LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jeremy Pene, NP
Nurse Practitioner
NPI 1184960403
6546 E 2ND ST STE C
Prescott Valley, AZ 86314
(928) 327-7528
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 03D2337353

Advantage Primary Health · Prescott Valley, AZ
Active · expires Jan 20, 2028
CLIA Number03D2337353
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 21, 2026
Certificate Expiration DateJanuary 20, 2028
Laboratory DirectorJeremy J. Pene
Laboratory Phone(928) 327-7528
Laboratory LocationAdvantage Primary Health6546 E Second St Ste C, Prescott Valley, AZ 86314
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Advantage Primary Health LLC's NPI number?

The NPI number for Advantage Primary Health LLC is 1477496032. It was assigned to this organization in the NPPES registry on April 9, 2026.

Where is Advantage Primary Health LLC located?

Advantage Primary Health LLC is located at 6546 E 2nd St Ste C, Prescott Valley, AZ 86314. The listed phone number is (928) 327-7528.

What is Advantage Primary Health LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Advantage Primary Health LLC enrolled in Medicare?

Yes. Advantage Primary Health LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advantage Primary Health LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Advantage Primary Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advantage Primary Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2337353) is associated with this NPI, valid through January 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 Advantage Primary Health LLC was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.