John Iverson

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6073 Issued in AZ

Practice address

743 Miller Valley Rd
Prescott, AZ 86301-1813

Phone

(928) 777-9600

Fax

(928) 777-9797

NPI assigned

May 24, 2014

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arizona Emergency Medicine Specialists PC

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1134439706
  Medicare reassignment
• Prescott Healthcare Solutions LLC

  dba Optima Medical

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  Medicare reassignment
• Tempe Emergency Physicians, LTD

  • Emergency Medicine Physician
  • Bullhead City, AZ
  • NPI 1376934315
  Medicare reassignment
• Yavapai Primary Care

  • Family Medicine Physician
  • Prescott Valley, AZ
  • NPI 1346871076
  Medicare reassignment
• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  AZ

  Medicare reassignment
• Arizona Adult and Pediatric Medicine PC

  • Internal Medicine Physician
  • Prescott, AZ
  • NPI 1225212905
  NPD (past)
• Carelock, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mayer, AZ
  • NPI 1972170322
  NPD (past)

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1467864470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 MILLER VALLEY RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011813",
            "telephone_number": "928-777-9600",
            "fax_number": "928-777-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 MILLER VALLEY RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011813",
            "telephone_number": "928-777-9600",
            "fax_number": "928-777-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-24",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinity Family Wellness
• Integrity Pain and Anesthesia PLLC (Integrity Pain and Wellness)
• Frank Iorio, MD
• Isd Renal Inc (Prescott Dialysis)
• Brianna Itter, LPC
• Michael Ivey, PHARMD
• J L & C Enterprises Inc (Goodwin Street Pharmacy)
• J Todd Cox PLLC (Yavapai Foot and Ankle Center)
• J. Brett Mangum DDS PC
• J&G Medical Services PLLC

• Medical Physician Assistant in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.