Individual provider Active NPI

Joshua Harrison, NP

  • Dermatology Physician
  • Fountain Hills, AZ
National Provider Identifier
1114405503
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
AP11596 Issued in AZ
Practice address
13771 N Fountain Hills Blvd # 114-103
Fountain Hills, AZ 85268-3762
Phone
(888) 662-3376
Fax
(786) 453-0383
NPI assigned
Jul 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP11596 AZ
Adult Health Nurse Practitioner 363LA2200X AP11596 AZ
Gerontology Nurse Practitioner 363LG0600X AP11596 AZ
Dermatology Physician 207N00000X AP11596 AZ Primary

Addresses

Primary practice location

13771 N Fountain Hills Blvd # 114-103
Fountain Hills, AZ 85268-3762

Mailing address

13771 N Fountain Hills Blvd # 114-103
Fountain Hills, AZ 85268-3762
Phone (888) 662-3376

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
I20190102001109 AZ Practitioner - Nurse Practitioner 3476898974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Dermright LLCGroup PAC ID 2567707060, 12 clinicians

Practice addresses (Care Compare)

Fountain Hills, AZ 85268
Phone (888) 662-3376

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermright LLC Dermatology CurrentSince Oct 16, 2018 Accepting new patients

Locations

13771 N Fountain Hills Blvd
#114103
Fountain Hills, AZ 85268
Phone (888) 662-3376

13771 N Fountain Hills Blvd
Ste 114103
Fountain Hls, AZ 85268
Phone (480) 352-1608

Organizations & group practices 1

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1114405503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13771 N FOUNTAIN HILLS BLVD # 114-103",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683762",
            "telephone_number": "888-662-3376",
            "fax_number": "786-453-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13771 N FOUNTAIN HILLS BLVD # 114-103",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683762",
            "telephone_number": "888-662-3376",
            "fax_number": "786-453-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JOSHUA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-10-01",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP11596",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP11596",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP11596",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "AP11596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

Verify at the official NPI Registry.