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IVY HEALTH PRIMARY CARE PLLC
NPI 1679214126
Nurse Practitioner - Family in Bullhead City, AZ

Active since April 06, 2022
2135 HIGHWAY 95 STE 135, BULLHEAD CITY, AZ 86442(928) 218-3493(928) 208-4829 Get Directions Write a Review

NPPES record last updated: October 3, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Oct 3, 2023, Oct 4, 2022, Jul 13, 2022 and 2 more (5 updates tracked since 2022).

About Ivy Health Primary Care Pllc NPPES

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

IVY HEALTH PRIMARY CARE PLLC (NPI 1679214126) is a healthcare organization registered as a family in Bullhead City, Arizona and active in the NPI registry since April 2022. The organization lists Sandra Reyes Mendoza, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1679214126
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameIVY HEALTH PRIMARY CARE PLLC
Location Address2135 HIGHWAY 95 STE 135Bullhead City, AZ 86442-6005
Mailing Address2135 Highway 95 Ste 135Bullhead City, AZ 86442-6005 · (928) 218-3493 · Fax (928) 268-0262
Phone(928) 218-3493
Fax(928) 208-4829
Organization SubpartNo
Authorized OfficialSandra Reyes MendozaNurse Practitioner · (928) 218-3493
Enumeration DateApril 6, 2022
Last NPPES UpdateOctober 3, 20235 updates tracked since enumeration
NPPES CertifiedOctober 3, 2023
✔ NPI 1679214126 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
2135 HIGHWAY 95 STE 135, Bullhead City, AZ 86442
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Other Identifiers 1

Other1417306978AZ · Npi

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 03D2264140

Ivy Health Primary Care PLLC · Bullhead City, AZ
Expired · Jul 10, 2026
CLIA Number03D2264140
Laboratory TypePractitioner Other
Certificate Effective DateJuly 11, 2024
Certificate Expiration DateJuly 10, 2026
Laboratory DirectorSandra Reyes-Mendoza
Laboratory Phone(928) 218-3493
Laboratory LocationIvy Health Primary Care PLLC2135 Highway 95 Ste 135, Bullhead City, AZ 86429
CLIA data matches this NPI record on: Address 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 Ivy Health Primary Care PLLC's NPI number?

The NPI number for Ivy Health Primary Care PLLC is 1679214126. It was assigned to this organization in the NPPES registry on April 6, 2022.

Where is Ivy Health Primary Care PLLC located?

Ivy Health Primary Care PLLC is located at 2135 Highway 95 Ste 135, Bullhead City, AZ 86442. The listed phone number is (928) 218-3493.

What is Ivy Health Primary Care PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Ivy Health Primary Care PLLC was last updated on October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.