Individual provider Active NPI

Nathan William Farnsworth, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1043064249
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
304081 Issued in AZ
Practice address
642 Dameron Dr
Prescott, AZ 86301-2411
Phone
(928) 445-5211
NPI assigned
Apr 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 304081 AZ Primary

Addresses

Primary practice location

642 Dameron Dr
Prescott, AZ 86301-2411

Mailing address

3343 N Windsong Dr
Prescott Valley, AZ 86314-1213
Phone (928) 445-5211

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
I20241205003585 AZ Practitioner - Nurse Practitioner 8123554722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Yavapai Guidance Clinic IncGroup PAC ID 3375524358, 21 clinicians

Practice addresses (Care Compare)

3345 N Windsong Dr
West Yavapai Primary Care
Prescott Valley, AZ 86314-2283
Phone (928) 583-6411

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Yavapai Guidance Clinic CurrentSince Aug 11, 2024 Accepting new patients
West Yavapai Guidance Clinic, Inc CurrentSince Aug 11, 2024 Accepting new patients

Locations

642 Dameron Dr
Prescott, AZ 86301
Phone 9284455211189

505 S Cortez St
Prescott, AZ 86303
Phone (602) 445-7730

3345 N Windsong Dr
Prescott Valley, AZ 86314
Phone (928) 583-6411

3343 N Windsong Dr
Prescott Vly, AZ 86314
Phone (406) 541-3669

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1043064249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141213",
            "telephone_number": "928-445-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 DAMERON DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012411",
            "telephone_number": "928-445-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "NATHAN",
        "middle_name": "WILLIAM",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "304081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.