Individual provider Active NPI

Marcia S Mulcahey, NP

  • Adult Health Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1386670024
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP8044 Issued in AZ
Practice address
919 12TH PL
Prescott, AZ 86305-1433
Phone
(602) 851-3030
Fax
(877) 357-9474
NPI assigned
Jun 24, 2006
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP8044 AZ Primary

Addresses

Primary practice location

919 12TH PL
Prescott, AZ 86305-1433

Mailing address

919 12TH PL
Prescott, AZ 86305-1433

Other identifiers 1

IdentifierTypeStateIssuer
279003MedicaidAZ

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
I20171027000943 AZ Practitioner - Nurse Practitioner 9234266347 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mulberry Medical LLCGroup PAC ID 2365954450, 30 clinicians

Practice addresses (Care Compare)

5801 S McClintock Dr
Suite 104
Tempe, AZ 85283-6002
Phone (623) 220-2602

919 12TH PL
Suite 5
Prescott, AZ 86305-1433
Phone (602) 820-8094

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP8044AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mulberry Medical LLC CurrentSince Mar 1, 2026 Accepting new patients
Peaks Primary Care, LLC CurrentSince Mar 15, 2024 Accepting new patients
Dalal Medical Corporation PastSince Aug 18, 2024 Accepting new patients
Plastic and Peripheral Nerve Surgery LLC PastSince Mar 1, 2026 Accepting new patients

Locations

919 12th Pl
Ste 5
Prescott, AZ 86305
Phone (602) 820-8094

919 12th Pl
Prescott, AZ 86305
Phone (602) 851-3030

5801 S McClintock Dr
Ste 104
Tempe, AZ 85283
Phone (623) 220-2601

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHHIDD
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1386670024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 12TH PL",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 12TH PL",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "602-851-3030",
            "fax_number": "877-357-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULCAHEY",
        "first_name": "MARCIA",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP8044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279003",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.