Individual provider Active NPI

Heather Marie Brooks, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1902693393
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
322524 Issued in AZ
Practice address
20195 E Raven Dr
Queen Creek, AZ 85142-3464
Phone
(602) 295-4265
NPI assigned
Apr 21, 2025
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 322524 AZ Primary

Addresses

Primary practice location

20195 E Raven Dr
Queen Creek, AZ 85142-3464

Mailing address

20195 E Raven Dr
Queen Creek, AZ 85142-3464
Phone (602) 295-4265

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
I20251009003023 AZ Practitioner - Nurse Practitioner 0042717522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1520 S Dobson Rd
Suite 206
Mesa, AZ 85202-4753
Phone (602) 462-0480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322524AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Oct 13, 2025 Accepting new patients
Banner - University Physician Specialists LLC Multi-Specialty CurrentSince Oct 13, 2025 Accepting new patients

Locations

1520 S Dobson Rd
Ste 206
Mesa, AZ 85202
Phone (480) 412-8080

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

Organizations & group practices 2

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.

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": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1902693393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20195 E RAVEN DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423464",
            "telephone_number": "602-295-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20195 E RAVEN DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423464",
            "telephone_number": "602-295-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "322524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.