PEAKS PRIMARY CARE, LLC
NPI 1700583879
Nurse Practitioner - Primary Care in Prescott, AZ
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
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peaks Primary Care, 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 Peaks Primary Care, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 03D2284875
Peaks Primary Care, The · Prescott, AZFrequently 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.
Is Peaks Primary Care, LLC enrolled in Medicare?
Yes. Peaks Primary Care, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Peaks Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Peaks Primary Care, 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 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.
# Peaks Primary Care, Llc · NPI 1700583879
Primary Care organization in Prescott, Arizona. Organization record, active in the CMS NPPES registry since February 9, 2023.
## Identity
- **NPI:** 1700583879 (Entity type: Organization)
- **Enumerated:** February 9, 2023
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Teri Ellerbe, ADMINISTRATOR
## Practice location
- **Address:** 919 12TH PL STE 5, Prescott, AZ 86305-1433
- **Phone:** (928) 582-6055 · **Fax:** (928) 445-0166
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 24, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1700583879) · Data from the CMS NPPES public registry.