Jacqueline Marie Harrison, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1008 E McDowell Rd Ste a
Phoenix, AZ 85006-2603

Phone

(602) 358-8588

Fax

(602) 688-6991

NPI assigned

Dec 10, 2020

Last updated

Nov 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kelly H Roy MD PCGroup PAC ID 3476526724, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.harrison.1@2541.direct.athenahealth.com

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.

• Kelly H. Roy, MD, PC

  • Gynecology Physician
  • Phoenix, AZ
  • NPI 1003099367
  Medicare reassignment Care Compare group
• WD Recovery and Wellness Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1669986998
  NPD (past)

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1760088009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 E MOUNTAIN VIEW RD UNIT 2068",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852586317",
            "telephone_number": "480-310-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 E MCDOWELL RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062603",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10115 E Mountain View Rd Unit 2068",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852586317",
            "country_code": "US",
            "telephone_number": "480-310-6934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 E Highland Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164876",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1151 N Gilbert Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852035127",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10555 N Tatum Blvd Ste A101",
            "address_purpose": "LOCATION",
            "city": "Paradise Valley",
            "state": "AZ",
            "postal_code": "852531096",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 E Bell Rd Ste 119",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850226639",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1919 E McKellips Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852032855",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Harris, MD
• Zoey Ilana Harris, MD
• Suzette Nicole Harrison-Morrison, MS, BCBA, LBA
• Alexander R Harrison, M.D.
• Geniel Harrison, MD
• Joseph M. Harrison, PA
• Katherine Marie Harrison
• Katherine Mary Harrison, MSW
• Lequenda Ileasha Harrison
• Michele Sproviero Harrison, M.D

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.
• 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.