Individual provider Active NPI

Danielle Fetting, PA

  • Medical Physician Assistant
  • Prescott, AZ
National Provider Identifier
1285002931
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8907 Issued in AZ
Practice address
1001 Willow Creek Rd Ste 2200
Prescott, AZ 86301-1614
Phone
(928) 445-6025
Fax
(928) 778-3026
NPI assigned
Sep 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7552 MA
Medical Physician Assistant 363AM0700X 8907 AZ Primary

Addresses

Primary practice location

1001 Willow Creek Rd Ste 2200
Prescott, AZ 86301-1614

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160120002387 FL Practitioner - Physician Assistant 5193028413 Reassigns benefits to 1 organization
I20220603001401 AZ Practitioner - Physician Assistant 5193028413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1003 Willow Creek Rd
Prescott, AZ 86301-1641

3120 Clearwater Dr
Prescott, AZ 86305-7131
Phone (928) 771-3704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8907AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince May 5, 2022 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Cardiovascular Disease CurrentSince May 5, 2022 Accepting new patients
Prescott Gastroenterology Past Accepting new patients
Comprehensive Healthcare Solutions LLC Past Accepting new patients

Locations

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

1001 Willow Creek Rd
Ste 2200
Prescott, AZ 86301
Phone (928) 445-6025

1003 Willow Creek Rd
Ste 1300
Prescott, AZ 86301

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1285002931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WILLOW CREEK RD STE 2200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011614",
            "telephone_number": "928-445-6025",
            "fax_number": "928-778-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTING",
        "first_name": "DANIELLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7552",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.