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PEAKS PRIMARY CARE, LLC
NPI 1700583879
Nurse Practitioner - Primary Care in Prescott, AZ

Active since February 09, 2023CLIA 03D2284875 · Waiver
919 12TH PL STE 5, PRESCOTT, AZ 86305(928) 582-6055(928) 445-0166 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 24, 2023, Feb 17, 2023, Feb 9, 2023 (3 updates tracked since 2023).

About Peaks Primary Care, Llc NPPES

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

PEAKS PRIMARY CARE, LLC (NPI 1700583879) is a healthcare organization registered as a primary care in Prescott, Arizona and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Teri Ellerbe, Administrator, as its authorized official.

NPPES Registry Identity

NPI1700583879
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NamePEAKS PRIMARY CARE, LLC
Location Address919 12TH PL STE 5Prescott, AZ 86305-1433
Mailing Address919 12th Pl Ste 5Prescott, AZ 86305-1433 · (928) 582-6055 · Fax (928) 445-0166
Phone(928) 582-6055
Fax(928) 445-0166
Organization SubpartNo
Authorized OfficialTeri EllerbeAdministrator · (602) 851-3030
Enumeration DateFebruary 9, 2023
Last NPPES UpdateOctober 24, 20233 updates tracked since enumeration
NPPES CertifiedOctober 24, 2023
✔ NPI 1700583879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
919 12TH PL STE 5, Prescott, AZ 86305
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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 03D2284875

Peaks Primary Care, The · Prescott, AZ
Active · expires Jun 28, 2027
CLIA Number03D2284875
Laboratory TypePrimary Care
Certificate Effective DateJune 29, 2025
Certificate Expiration DateJune 28, 2027
Laboratory DirectorTeri L. Ellerbe
Laboratory Phone(302) 820-8094
Laboratory LocationPeaks Primary Care, The919 12th Place Ste 5, Prescott, AZ 86305
CLIA data matches this NPI record on: Name
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.

AZHOMEHEALTH LLC
Home Health
919 12TH PL STE 5
PRESCOTT, AZ 86305
Yavapai County (602) 535-0610

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 Peaks Primary Care, LLC's NPI number?

The NPI number for Peaks Primary Care, LLC is 1700583879. It was assigned to this organization in the NPPES registry on February 9, 2023.

Where is Peaks Primary Care, LLC located?

Peaks Primary Care, LLC is located at 919 12th Pl Ste 5, Prescott, AZ 86305. The listed phone number is (928) 582-6055.

What is Peaks Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Peaks Primary Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2284875) is associated with this NPI, valid through June 28, 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 Peaks Primary Care, LLC was last updated on October 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.