Individual provider Active NPI

Susan Carol Harris, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1083988489
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11239 Issued in AZ
Practice address
7227 E Baseline Rd Ste 126
Mesa, AZ 85209-5006
Phone
(480) 868-9650
Fax
(480) 834-3606
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0212354 MN
Family Nurse Practitioner 363LF0000X AP11239 AZ Primary

Addresses

Primary practice location

7227 E Baseline Rd Ste 126
Mesa, AZ 85209-5006

Mailing address

7227 E Baseline Rd Ste 126
Mesa, AZ 85209-5006
Phone (480) 868-9650

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
I20180718004133 AZ Practitioner - Nurse Practitioner 5799947933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Medical Aco LLCGroup PAC ID 1456885227, 50 clinicians
Century Care IncGroup PAC ID 3971665605, 51 clinicians

Practice addresses (Care Compare)

7227 E Baseline Rd
Suite 126
Mesa, AZ 85209-5006
Phone (480) 868-9650

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP11239AZMDFamily Nurse Practitioner
F0212354MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1083988489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 E BASELINE RD STE 126",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095006",
            "telephone_number": "480-868-9650",
            "fax_number": "480-834-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 E BASELINE RD STE 126",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095006",
            "telephone_number": "480-868-9650",
            "fax_number": "480-834-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SUSAN",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F0212354",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.