NPIMap

Individual provider Active NPI

Michelle T. Harbottle, PA-C

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1043720584
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6925 Issued in AZ
Practice address
811 S Hamilton St
Chandler, AZ 85225-6308
Phone
(480) 344-6100
Fax
(480) 344-6101
NPI assigned
Oct 11, 2017
Last updated
Nov 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6925 AZ Primary

Addresses

Primary practice location

811 S Hamilton St
Chandler, AZ 85225-6308

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114002860 AZ Practitioner - Physician Assistant 2668738204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

33 W Tamarisk St
Phoenix, AZ 85041-2422
Phone (602) 344-6400

811 S Hamilton St
Chandler, AZ 85225-6308
Phone (480) 344-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6925AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maricopa County Special Health Care District Current Accepting new patients
District Medical Group, Inc CurrentSince Oct 23, 2017 Accepting new patients
Maricopa County Special Heallth Care District CurrentSince Oct 4, 2017 Accepting new patients
District Medical Group, Inc CurrentSince Oct 23, 2017 Accepting new patients
Maricopa County Special Health Care District CurrentSince Oct 4, 2017 Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients
District Medical Group, Inc Past Accepting new patients

Locations

950 E Van Buren St
Avondale, AZ 85323
Phone (623) 344-6800

811 S Hamilton St
Chandler, AZ 85225
Phone (480) 344-6100

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

Interoperability endpoints

  • Direct secure messaging: mharbottle125711@direct.valleywisehealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1043720584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S HAMILTON ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256308",
            "telephone_number": "480-344-6100",
            "fax_number": "480-344-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBOTTLE",
        "first_name": "MICHELLE",
        "middle_name": "T.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.