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HEALTHFUL HEALTHCARE PLLC
NPI 1811603202
Nurse Practitioner - Primary Care in Surprise, AZ

Active since January 30, 2023CLIA 03D2279857 · Waiver
14961 W BELL RD STE 100, SURPRISE, AZ 85374(623) 439-5176(855) 583-1420 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 10, 2023, Jan 30, 2023 (2 updates tracked since 2023).

About Healthful Healthcare Pllc NPPES

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

HEALTHFUL HEALTHCARE PLLC (NPI 1811603202) is a healthcare organization registered as a primary care in Surprise, Arizona and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through April 9, 2027 and lists Stephanie Blackmore, Owner/ Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1811603202
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameHEALTHFUL HEALTHCARE PLLC
Location Address14961 W BELL RD STE 100Surprise, AZ 85374-3203
Mailing Address14961 W Bell Rd Ste 100Surprise, AZ 85374-3203 · (623) 606-5524
Phone(623) 439-5176
Fax(855) 583-1420
Organization SubpartNo
Authorized OfficialStephanie BlackmoreOwner/ Nurse Practitioner · (623) 439-5176
Enumeration DateJanuary 30, 2023
Last NPPES UpdateOctober 10, 20232 updates tracked since enumeration
NPPES CertifiedOctober 10, 2023
✔ NPI 1811603202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
Also ListedNurse PractitionerTaxonomy 363L00000X
14961 W BELL RD STE 100, Surprise, AZ 85374
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Healthful Healthcare Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Healthful Healthcare PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Stephanie Blackmore, FNP
Nurse Practitioner
NPI 1366052771
14961 W BELL RD STE 100
Surprise, AZ 85374
(623) 439-5176
✔ PECOS✔ Accepts MedicareSame address
Maria Silva, FNP-C
Nurse Practitioner
NPI 1346016102
3864 N 27TH AVE
Phoenix, AZ 85017
(602) 685-6000
✔ PECOS✔ Accepts Medicare18 mi

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 03D2279857

Healthful Healthcare PLLC · Surprise, AZ
Active · expires Apr 9, 2027
CLIA Number03D2279857
Laboratory TypePhysician Office
Certificate Effective DateApril 10, 2025
Certificate Expiration DateApril 9, 2027
Laboratory DirectorStephanie E. Blackmore
Laboratory Phone(623) 439-5178
Laboratory LocationHealthful Healthcare PLLC14961 W Bell Rd Ste 100, Surprise, AZ 85374
CLIA data matches this NPI record on: Address Name
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 Healthful Healthcare PLLC's NPI number?

The NPI number for Healthful Healthcare PLLC is 1811603202. It was assigned to this organization in the NPPES registry on January 30, 2023.

Where is Healthful Healthcare PLLC located?

Healthful Healthcare PLLC is located at 14961 W Bell Rd Ste 100, Surprise, AZ 85374. The listed phone number is (623) 439-5176.

What is Healthful Healthcare PLLC's specialty?

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

Is Healthful Healthcare PLLC enrolled in Medicare?

Yes. Healthful Healthcare PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Healthful Healthcare PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Healthful Healthcare PLLC. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Healthful Healthcare PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2279857) is associated with this NPI, valid through April 9, 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 Healthful Healthcare PLLC was last updated on October 10, 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.