Active NPI
Phillip Allen Schafer, AGACNP-BC
- Acute Care Nurse Practitioner
- Prescott, AZ
National Provider Identifier
1790276608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- AP11322
- Practice address
- 212 S Montezuma St Ste 3
Prescott, AZ 86303-4720 - Phone
- (928) 277-0001
- Fax
- (928) 350-6228
- NPI assigned
- May 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | AP11322 | AZ | Primary |
| Family Nurse Practitioner | 363LF0000X | AP11311 | AZ |
Addresses
Primary practice location
212 S Montezuma St Ste 3
Prescott, AZ 86303-4720
Mailing address
212 S Montezuma St Ste 3
Prescott, AZ 86303-4720
Phone (928) 277-0001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437992112 | Other | AZ | GRANITE MOUNTAIN LLC |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP11311 | AZ | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741737600000",
"number": "1790276608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 S MONTEZUMA ST STE 3",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863034720",
"telephone_number": "928-277-0001",
"fax_number": "928-350-6228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 S MONTEZUMA ST STE 3",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863034720",
"telephone_number": "928-277-0001",
"fax_number": "928-350-6228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAFER",
"first_name": "PHILLIP",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-25",
"last_updated": "2025-03-12",
"certification_date": "2025-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AZ",
"license": "AP11322",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP11311",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GRANITE MOUNTAIN LLC",
"identifier": "1437992112",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.