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

Q: 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.

Q: 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.

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: May 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 2, 2026, Apr 17, 2026, Apr 9, 2026 (3 updates tracked since 2026).

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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 UpdateMay 2, 20263 updates tracked since enumeration

NPPES CertifiedMay 2, 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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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.

Other Providers at the Same Location NPPES 6

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

JEREMY JAMES PENE NP

Nurse Practitioner (Family)