Individual provider Active NPI

Joan Meyers, PAC

  • Physician Assistant
  • Prescott, AZ
National Provider Identifier
1184652075
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AZ1390 Issued in AZ
Practice address
726 Gail Gardner Way
Prescott, AZ 86305-2337
Phone
(928) 445-5211
Fax
(928) 445-5189
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 AP1204 AZ
Physician Assistant 363A00000X AZ1390 AZ Primary

Addresses

Primary practice location

726 Gail Gardner Way
Prescott, AZ 86305-2337

Mailing address

726 Gail Gardner Way
Prescott, AZ 86305-2337
Phone (928) 445-5211

Other identifiers 1

IdentifierTypeStateIssuer
110255MedicaidAZ

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
I20141219002170 AZ Practitioner - Physician Assistant 1951624113 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AZ1390AZMDPhysician Assistant
AP1204AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connectionsaz, LLC CurrentSince Nov 15, 2014 Accepting new patients
West Yavapai Guidance Clinic, Inc Past Accepting new patients
Community Partners Integrated Healthcare, Inc. PastSince Dec 16, 2020 Accepting new patients
West Yavapai Guidance Clinic PastSince Oct 6, 2024 Accepting new patients
Trinity West Past Accepting new patients
Medical Services of Prescott, Inc. Past Accepting new patients
Community Partners Integrated Healthcare, Inc. Past Accepting new patients

Locations

1201 S 7th Ave
Ste 150
Phoenix, AZ 85007
Phone (602) 253-5100

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1184652075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 GAIL GARDNER WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863052337",
            "telephone_number": "928-445-5211",
            "fax_number": "928-445-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 GAIL GARDNER WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863052337",
            "telephone_number": "928-445-5211",
            "fax_number": "928-445-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "JOAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP1204",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "AZ1390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110255",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.