Individual provider Active NPI

John Andrew Prosser Jr., MSN, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1053746503
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP5143 Issued in AZ
Practice address
2640 W Baseline Rd
Suite 111
Phoenix, AZ 85041-6492
Phone
(480) 677-8282
Fax
(480) 677-8283
NPI assigned
Sep 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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 AP5143 AZ Primary

Addresses

Primary practice location

2640 W Baseline Rd
Suite 111
Phoenix, AZ 85041-6492

Mailing address

4600 S Mill Ave
Ste 280
Tempe, AZ 85282-6850
Phone (480) 305-2888

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
I20131018000171 AZ Practitioner - Nurse Practitioner 9234363680 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP5143AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Post-Acute Medical Services 1 PC CurrentSince Apr 1, 2017 Accepting new patients
NM Pacs 2 LLC CurrentSince Sep 23, 2020 Accepting new patients
CS Pacs 3 West LLC CurrentSince Aug 31, 2024 Accepting new patients
Hospitalists of Arizona, LLC Past Accepting new patients
Red Mountain Healthcare LLC Past Accepting new patients
Good Health Medical, PLLC Past Accepting new patients
Livn, P.C. Past Accepting new patients
Higley Healthcare, Inc. Past Accepting new patients

Locations

2012 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 938-0700

13620 N 55th Ave
Glendale, AZ 85304
Phone (602) 588-1047

1081 Kathleen Ave
Kingman, AZ 86401
Phone (928) 718-0777

5755 E Main St
Mesa, AZ 85205
Phone (480) 214-2400

5121 E Broadway Rd
Mesa, AZ 85206
Phone (480) 296-2680

3130 E Broadway Rd
Mesa, AZ 85204
Phone (480) 924-7777

255 W Brown Rd
Mesa, AZ 85201
Phone (480) 833-3988

8825 S 7th St
Phoenix, AZ 85042
Phone (602) 243-6121

2510 W Dunlap Ave
Ste 209
Phoenix, AZ 85021

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021

2510 W Dunlap Ave
Phoenix, AZ 85021
Phone (970) 310-7517

864 Dougherty St
Prescott, AZ 86305
Phone (928) 778-9666

1045 Scott Dr
Prescott, AZ 86301
Phone (928) 717-1560

3380 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 775-0045

2401 E Hunt Dr
Show Low, AZ 85901
Phone (928) 537-5333

Interoperability endpoints

  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1053746503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 S MILL AVE",
            "address_2": "STE 280",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826850",
            "telephone_number": "480-305-2888",
            "fax_number": "480-305-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W BASELINE RD",
            "address_2": "SUITE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416492",
            "telephone_number": "480-677-8282",
            "fax_number": "480-677-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_suffix": "Jr.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.