Individual provider Active NPI

Casandra Harmon

  • Pediatric Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1629829247
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
337578 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-3366
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2485593 MN
Pediatric Nurse Practitioner 363LP0200X 337578 AZ Primary
Pediatric Registered Nurse 163WP0200X 332198 NC

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-3366

Other names 1

  • Casandra Kopischke Former name

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
I20260617002552 AZ Practitioner - Nurse Practitioner 0244702587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2108 E Thomas Rd
Suite 130
Phoenix, AZ 85016-0008

2108 E Thomas Rd
Suite 130
Phoenix, AZ 85016-7761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2485593MNMDRegistered Nurse
332198NCMDPediatric Registered Nurse

Organizations & group practices 1

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": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1629829247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON",
        "first_name": "CASANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2485593",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "337578",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NC",
            "license": "332198",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASANDRA",
            "last_name": "KOPISCHKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.