Jessica Fain, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6507 Issued in AZ

Practice address

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831

Phone

(928) 537-6371

NPI assigned

Oct 29, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Carbon Health Medical Group of California PC

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment Care Compare group NPD
• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716
  Medicare reassignment
• New York Westchester SQ Med Ctr

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1851340608
  NPD (past)
• RTW Health Services LLC

  • Emergency Medicine Physician
  • Atlanta, GA
  • NPI 1760081657
  NPD (past)

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

{
    "created_epoch": "1477699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477699200000",
    "number": "1104378702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-29",
        "last_updated": "2016-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• El Rio Santa Cruz Neighborhood Health Center, Inc.
• Curtis Ellsworth
• Ty Ellsworth, DMD
• Endo Associates
• Jeannie D Evans, D.O.
• Familyfirst Counseling & Behavioral Healthy Services, Inc.
• Fancy Anesthesia Services Inc
• Krista M Farr, DDS
• Fawcett Chiropractic Inc
• David L Fawcett, D.C.

• Physician Assistant in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.