GOODYEAR FAMILY NURSE PRACTICE LLC
NPI 1619740685
Clinic/Center - Primary Care in Avondale, AZ
About Goodyear Family Nurse Practice Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOODYEAR FAMILY NURSE PRACTICE LLC (NPI 1619740685) is a healthcare organization registered as a primary care in Avondale, Arizona and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through September 1, 2027 and lists Kesasi Marsh, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 03D2329615
Goodyear Family Nurse Practice · Avondale, AZOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
AVONDALE, AZ 85392
AVONDALE, AZ 85392
AVONDALE, AZ 85392
AVONDALE, AZ 85392
AVONDALE, AZ 85392
AVONDALE, AZ 85392
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 Goodyear Family Nurse Practice LLC's NPI number?
The NPI number for Goodyear Family Nurse Practice LLC is 1619740685. It was assigned to this organization in the NPPES registry on November 1, 2023.
Where is Goodyear Family Nurse Practice LLC located?
Goodyear Family Nurse Practice LLC is located at 12725 W Indian School Rd Ste E101, Avondale, AZ 85392. The listed phone number is (623) 471-9043.
What is Goodyear Family Nurse Practice LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Goodyear Family Nurse Practice LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2329615) is associated with this NPI, valid through September 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Goodyear Family Nurse Practice LLC was last updated on August 27, 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.
# Goodyear Family Nurse Practice Llc · NPI 1619740685
Primary Care organization in Avondale, Arizona. Organization record, active in the CMS NPPES registry since November 1, 2023.
## Identity
- **NPI:** 1619740685 (Entity type: Organization)
- **Enumerated:** November 1, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Kesasi Marsh, OWNER
## Practice location
- **Address:** 12725 W INDIAN SCHOOL RD STE E101, Avondale, AZ 85392-9525
- **Phone:** (623) 471-9043
## Record status
- **NPPES last updated:** August 27, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619740685) · Data from the CMS NPPES public registry.