Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JILL FAGAN PMHNP-BC
NPI 1417863002
Nurse Practitioner - Psychiatric/Mental Health in Prescott, AZ

Q: What is Jill Fagan's NPI number?

The NPI number for Jill Fagan is 1417863002. It was assigned to this individual provider in the NPPES registry on August 21, 2026.

Q: What is Jill Fagan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Jill Fagan was last updated on September 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 21, 2026PECOS Enrolled

743 MILLER VALLEY RD, PRESCOTT, AZ 86301(928) 777-9600(855) 449-5560 Get Directions Write a Review

NPPES record added: September 15, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Sep 15, 2026, Aug 30, 2026, Aug 21, 2026 (3 updates tracked since 2026).

On this page

About Jill Fagan Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JILL FAGAN PMHNP-BC (NPI 1417863002) is an individual psychiatric/mental health provider in Prescott, Arizona, licensed in Arizona (259190) and active in the NPI registry since August 2026. She is enrolled in Medicare PECOS and maintains 28 additional practice locations.

NPPES Registry Identity

NPI1417863002

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameJILL FAGANCredential: PMHNP-BC

Location Address743 MILLER VALLEY RDPrescott, AZ 86301-1813

Mailing Address743 Miller Valley RdPrescott, AZ 86301-1813 · (928) 777-9600 · Fax (855) 449-5560

Phone(928) 777-9600

Fax(855) 449-5560

Sole ProprietorYes

Enumeration DateAugust 21, 2026

Last NPPES UpdateSeptember 15, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 15, 2026

✔ NPI 1417863002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in AZ · 259190

743 MILLER VALLEY RD, Prescott, AZ 86301

Open in Google Maps ↗

Secondary Practice Locations 28

Location 1725 W Elliot Rd Bldg 3Gilbert, AZ 85233-5301 · Phone (480) 963-6144 · Fax (480) 899-1404

Location 226224 N Tatum BlvdPhoenix, AZ 85050-7500 · Phone (480) 663-9632 · Fax (623) 748-1914

Location 313926 W Bell RdSurprise, AZ 85374-3863 · Phone (623) 850-0026 · Fax (623) 850-0027

Location 49171 W Thunderbird Rd Ste 101Peoria, AZ 85381-4872 · Phone (623) 877-0100 · Fax (623) 328-8713

Location 53552 W Baseline Rd Ste 140Laveen, AZ 85339-3042 · Phone (602) 635-6951 · Fax (602) 635-6952

Location 61923 McCulloch Blvd N Ste 101Lake Havasu City, AZ 86403-6120 · Phone (928) 208-4611 · Fax (928) 453-4645

Location 73931 N Stockton Hill RdKingman, AZ 86409-2426 · Phone (928) 385-7100 · Fax (885) 538-3114

Location 83530 S Val Vista Dr Ste C101Gilbert, AZ 85297-7318 · Phone (480) 840-9155 · Fax (480) 840-9320

Location 92035 Mesquite AveLake Havasu City, AZ 86403-5894 · Phone (928) 208-4598 · Fax (888) 571-6436

Location 10309 Lake Havasu Ave SLake Havasu City, AZ 86403-9309 · Phone (928) 453-1970 · Fax (928) 855-7229

Location 11285 N Broad StGlobe, AZ 85501-2503 · Phone (928) 425-8200 · Fax (928) 425-8406

Location 123336 E Chandler Heights Rd Ste 132Gilbert, AZ 85298-4264 · Phone (480) 988-4645 · Fax (480) 988-4745

Location 134135 S Power Rd Ste 129Mesa, AZ 85212-3627 · Phone (480) 751-3091 · Fax (480) 751-3095

Location 1421321 E Ocotillo Rd Ste 133Queen Creek, AZ 85142-5995 · Phone (480) 987-5525 · Fax (480) 987-5115

Location 1518275 N 59th AveGlendale, AZ 85308-1260 · Phone (602) 564-0078 · Fax (602) 564-1154

Location 165902 E Pima StTucson, AZ 85712-4322 · Phone (520) 886-5315 · Fax (877) 209-7377

Location 17286 S Lenzner AveSierra Vista, AZ 85635-5685 · Phone (520) 452-0388 · Fax (877) 281-8622

Location 182171 W Orange Grove RdTucson, AZ 85741-3118 · Phone (520) 297-3907 · Fax (520) 989-3486

Location 191620 E Wilcox DrSierra Vista, AZ 85635-2778 · Phone (520) 459-0362 · Fax (520) 458-1585

Location 202500 Canyon Rd Ste A1Bullhead City, AZ 86442-8492 · Phone (928) 704-4499 · Fax (928) 704-4949

Location 211300 S 20th AveSafford, AZ 85546-3301 · Phone (928) 428-3122 · Fax (928) 428-7917

Location 223251 N Windsong DrPrescott Valley, AZ 86314-1222 · Phone (928) 772-2582 · Fax (928) 319-1729

Location 2312075 E State Route 69 Ste BPrescott Valley, AZ 86327-4569 · Phone (928) 772-1673 · Fax (928) 772-1674

Location 24450 S Willard StCottonwood, AZ 86326-6743 · Phone (928) 634-9573 · Fax (928) 634-0135

Location 2587 S State Route 89Chino Valley, AZ 86323-5687 · Phone (928) 404-1488 · Fax (866) 232-8580

Location 2624871 S Ellsworth Rd Ste 100-458Queen Creek, AZ 85142-1574 · Phone (602) 300-0898

Location 272501 N Stockton Hill Rd Ste 108Kingman, AZ 86401-4140 · Phone (928) 255-5050 · Fax (888) 571-5897

Location 28560 N Camino Mercado Ste 7Casa Grande, AZ 85122-5759 · Phone (520) 836-5538 · Fax (844) 722-0049

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jill Fagan Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT ADAM GREGOROWICZ PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)