| Active Vital Care LLC | |
|
1928 E Highland Ave Ste F104 Phoenix AZ 85016-4626 | |
| (833) 242-0100 | |
| (623) 889-0814 |
| Full Name | Active Vital Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1928 E Highland Ave Ste F104, Phoenix, Arizona |
| Authorized Official Name and Position | Drew Sturgis (OWNER) |
| Authorized Official Contact | 6616441259 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Vital Care LLC Po Box 755 Scottsdale AZ 85252-0755 Ph: (833) 242-0100 | Active Vital Care LLC 1928 E Highland Ave Ste F104 Phoenix AZ 85016-4626 Ph: (833) 242-0100 |
| NPI Number | 1326825092 |
|---|---|
| Provider Enumeration Date | 09/14/2023 |
| Last Update Date | 09/25/2025 |
| Certification Date | 09/25/2025 |
| Medicare PECOS PAC ID | 3870942428 |
|---|---|
| Medicare Enrollment ID | O20231208000557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326825092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Larry Travis Heap |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366418113 PECOS PAC ID: 5991752909 Enrollment ID: I20050401000473 |
| Provider Name | Raymond R Botte |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1083674857 PECOS PAC ID: 5193743144 Enrollment ID: I20051108000479 |
| Provider Name | Kristina T Werner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174506547 PECOS PAC ID: 7113946971 Enrollment ID: I20051122000297 |
| Provider Name | Susan Mary Albright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154354306 PECOS PAC ID: 8921073529 Enrollment ID: I20061204000008 |
| Provider Name | Micole D Neely |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437344264 PECOS PAC ID: 4981760931 Enrollment ID: I20090227000232 |
| Provider Name | Richard a Wall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811971393 PECOS PAC ID: 9638211329 Enrollment ID: I20100119000165 |
| Provider Name | Lisa Swansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811298003 PECOS PAC ID: 7911195847 Enrollment ID: I20101220000653 |
| Provider Name | Anna Christine Stelter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497006795 PECOS PAC ID: 6204087398 Enrollment ID: I20121120000172 |
| Provider Name | Bradley Wayne Hughes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821318262 PECOS PAC ID: 7618291014 Enrollment ID: I20150113000383 |
| Provider Name | Kevin S. Broaddrick |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639188394 PECOS PAC ID: 1951393867 Enrollment ID: I20150723007902 |
| Provider Name | Marcus Morris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447608435 PECOS PAC ID: 0749573566 Enrollment ID: I20160801001054 |
| Provider Name | Dien T DO |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609326289 PECOS PAC ID: 9830477256 Enrollment ID: I20161104001524 |
| Provider Name | Daniel Douglas Kiddy |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144214529 PECOS PAC ID: 2567414030 Enrollment ID: I20180628002708 |
| Provider Name | Rebecca Maree Hoover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457851826 PECOS PAC ID: 7113270414 Enrollment ID: I20181105000299 |
| Provider Name | Nkemdirim Obiora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497258727 PECOS PAC ID: 5799039814 Enrollment ID: I20181108000864 |
| Provider Name | James Warren Reznick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659376689 PECOS PAC ID: 7911187174 Enrollment ID: I20190226000587 |
| Provider Name | Rebecca L Schoenherr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255582359 PECOS PAC ID: 7517014186 Enrollment ID: I20190228000869 |
| Provider Name | Lynn a Wanderer-potter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174633994 PECOS PAC ID: 2567472236 Enrollment ID: I20200826001458 |
| Provider Name | Maria Kojs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952915449 PECOS PAC ID: 9234559824 Enrollment ID: I20201021000197 |
| Provider Name | Adi Pajazetovic |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225527443 PECOS PAC ID: 4385048057 Enrollment ID: I20210803003612 |
| Provider Name | Donia Ibrahim |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275159840 PECOS PAC ID: 3375932429 Enrollment ID: I20211111002273 |
| Provider Name | Carlos DV Montes Domini |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1528043429 PECOS PAC ID: 0840193355 Enrollment ID: I20220202002428 |
| Provider Name | Kristen N Murray |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528346145 PECOS PAC ID: 8729306121 Enrollment ID: I20220309002735 |
| Provider Name | Jonathan Robert Martens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184335085 PECOS PAC ID: 0547625824 Enrollment ID: I20230421000587 |
| Provider Name | Anne Ngaruiya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962109785 PECOS PAC ID: 2365786142 Enrollment ID: I20230718001785 |
| Provider Name | Matilda Boachie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306571468 PECOS PAC ID: 1052766474 Enrollment ID: I20231004003332 |
| Provider Name | Michele Helen Roberts |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689385692 PECOS PAC ID: 9931556875 Enrollment ID: I20231114002216 |
| Provider Name | Renae T Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205432705 PECOS PAC ID: 8022457878 Enrollment ID: I20240412003682 |
| Provider Name | Scott Adam Gregorowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023844388 PECOS PAC ID: 3476085036 Enrollment ID: I20241021002238 |
| Provider Name | Michael Volk Stewart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679845713 PECOS PAC ID: 4082875877 Enrollment ID: I20241117000059 |
| Provider Name | Carissa Suzanne Abe |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1376987875 PECOS PAC ID: 6800323965 Enrollment ID: I20241231002382 |
| Provider Name | Raghad Musa Salame Batarseh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710794599 PECOS PAC ID: 7618406166 Enrollment ID: I20250128004170 |
| Provider Name | Jenny Marie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558173864 PECOS PAC ID: 4981125226 Enrollment ID: I20250304000825 |
| Provider Name | Randy V Mallari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306198429 PECOS PAC ID: 8628220118 Enrollment ID: I20250408002298 |
| Provider Name | Alyssa Marie Gentile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144017310 PECOS PAC ID: 6204353899 Enrollment ID: I20250507001467 |
| Provider Name | Geraldine Salvio Guthrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073338380 PECOS PAC ID: 6002333226 Enrollment ID: I20250509002794 |
| Provider Name | Jocelyn Abueva Dimeco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831914027 PECOS PAC ID: 4981122033 Enrollment ID: I20250513002591 |
| Provider Name | Ya Huster Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720547425 PECOS PAC ID: 5395170567 Enrollment ID: I20250527000408 |
| Provider Name | Rex Rios Doctor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376433995 PECOS PAC ID: 2466959556 Enrollment ID: I20251007001023 |
| Provider Name | Sandra Paula Bazan-olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083864136 PECOS PAC ID: 6002382645 Enrollment ID: I20260420003559 |
Richard A. Snider, MD, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 |
Kelly H. Roy, MD, PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 |
My Family Doctor in the Valley PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 |
Deborah L Dykema DO PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 |
Scottsdale Housecall Physicians, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 |
Wings of Hope Medical Services, LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 270, Phoenix, AZ 85029 Phone: 623-404-8505 Fax: 602-429-8475 |