Individual provider Active NPI

John Heber Jarvis, M.D.

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1104024843
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4568 Issued in AZ
Practice address
5440 E Calle del Medio
Phoenix, AZ 85018-4530
Phone
(602) 840-7569
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4568 AZ Primary

Addresses

Primary practice location

5440 E Calle del Medio
Phoenix, AZ 85018-4530

Mailing address

5440 E Calle del Medio
Phoenix, AZ 85018-4530
Phone (602) 840-7569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4568AZMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104024843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 E CALLE DEL MEDIO",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850184530",
            "telephone_number": "602-840-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 E CALLE DEL MEDIO",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850184530",
            "telephone_number": "602-840-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "JOHN",
        "middle_name": "HEBER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "4568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.