HEALTHY YOU PERSONALIZED PRIMARY CARE
NPI 1780473785
Family Medicine in Las Cruces, NM

Q: What is Healthy You Personalized Primary Care's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since May 05, 2025CLIA 32D2325451 · Waiver

1240 S TELSHOR BLVD STE A, LAS CRUCES, NM 88011(575) 915-8821 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Healthy You Personalized Primary Care NPPES

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

HEALTHY YOU PERSONALIZED PRIMARY CARE (NPI 1780473785) is a healthcare organization registered as a family medicine in Las Cruces, New Mexico and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through June 11, 2027, maintains a secondary practice location in Las Cruces, and lists Amanda B. Provencio, Owner, as its authorized official.

NPPES Registry Identity

NPI1780473785

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameHEALTHY YOU PERSONALIZED PRIMARY CARE

Location Address1240 S TELSHOR BLVD STE ALas Cruces, NM 88011-4731

Mailing Address1240 S Telshor Blvd Ste ALas Cruces, NM 88011-4731 · (575) 259-3638 · Fax (855) 538-0781

Phone(575) 915-8821

Organization SubpartNo

Authorized OfficialAmanda B. ProvencioOwner · (575) 259-3638

Enumeration DateMay 5, 2025

Last NPPES UpdateAugust 25, 2025

NPPES CertifiedAugust 23, 2025

✔ NPI 1780473785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1240 S TELSHOR BLVD STE A, Las Cruces, NM 88011

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Secondary Practice Location 1

Location 14441 E Lohman AveLas Cruces, NM 88011-8267 · Phone (575) 915-8821

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 32D2325451

Healthy You Personalized Primary Care · Las Cruces, NM

Active · expires Jun 11, 2027

CLIA Number32D2325451

Laboratory TypePhysician Office

Certificate Effective DateJune 12, 2025

Certificate Expiration DateJune 11, 2027

Laboratory DirectorAmanda B. Provencio

Laboratory Phone(575) 915-8821

Laboratory LocationHealthy You Personalized Primary Care1240 S Telshor Blvd Ste A, Las Cruces, NM 88011

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MESILLA VALLEY PAIN CLINIC, LLC

Clinic/Center (Pain)