Individual provider Active NPI

Justin Harkins

  • Certified Registered Nurse Anesthetist
  • Scottsdale, AZ
National Provider Identifier
1477918878
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA1200 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone
(480) 301-8000
NPI assigned
Dec 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA1200 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520002229 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264731652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rector and Visitors of the University of VirginiaGroup PAC ID 4789592718, 96 clinicians

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-0000

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA1200AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rector & Visitors of the University of Virginia CurrentSince Mar 7, 2021 Accepting new patients
Rector and Visitors of the University of Virginia Nurse Anesthetist, Certified Registered CurrentSince Mar 7, 2021 Accepting new patients
Rector & Visitors of the University of Virginia Current Accepting new patients

Locations

2955 Ivy Rd
Ste 201
Charlottesvle, VA 22903
Phone (434) 243-4520

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

Organizations & group practices 3

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": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1477918878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKINS",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-30",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.