Individual provider Active NPI

Mickey Lynn Houston, NP,APRN

  • Adult Health Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1700988771
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
198439-4405 Issued in UT
Practice address
930 N Switzer Canyon Dr
Suite 202
Flagstaff, AZ 86001-4824
Phone
(928) 779-5707
Fax
(928) 779-5753
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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 198439-4405 UT Primary

Addresses

Primary practice location

930 N Switzer Canyon Dr
Suite 202
Flagstaff, AZ 86001-4824

Mailing address

930 N Switzer Canyon Dr
Suite 202
Flagstaff, AZ 86001-4824
Phone (928) 779-5707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198439-4405UTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Edge Medical PastSince Oct 1, 2018 Accepting new patients
Northwoods Medical Associates, P.C. PastSince Jul 1, 2008 Accepting new patients
Judd L Larowe MD PC PastSince Jan 2, 2002 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGGGBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1700988771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 N SWITZER CANYON DR",
            "address_2": "SUITE 202",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014824",
            "telephone_number": "928-779-5707",
            "fax_number": "928-779-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N SWITZER CANYON DR",
            "address_2": "SUITE 202",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014824",
            "telephone_number": "928-779-5707",
            "fax_number": "928-779-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "MICKEY",
        "middle_name": "LYNN",
        "credential": "NP,APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "UT",
            "license": "198439-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.