Individual provider Active NPI

Cassidy S Murphy, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1033876024
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
257319 Issued in AZ
Practice address
1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162
Phone
(480) 827-5500
NPI assigned
Nov 24, 2021
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 257319 AZ Primary

Addresses

Primary practice location

1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162

Mailing address

1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162
Phone (480) 827-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220103000002 AZ Practitioner - Nurse Practitioner 0446641369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 S Country Club Dr
Suite 3
Mesa, AZ 85210-5162
Phone (480) 827-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
257319AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Dec 1, 2021 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

1300 S Country Club Dr
Ste 3
Mesa, AZ 85210
Phone (480) 827-5500

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1033876024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S COUNTRY CLUB DR STE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105162",
            "telephone_number": "480-827-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S COUNTRY CLUB DR STE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105162",
            "telephone_number": "480-827-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "CASSIDY",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "257319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.