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PROVIDER PROVIDER PC
NPI 1760969190
General Practice in Mesa, AZ

Active since July 28, 2018

NPPES record last updated: December 20, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 20, 2018, Jul 28, 2018 (2 updates tracked since 2018).

About Provider Provider Pc NPPES

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

PROVIDER PROVIDER PC (NPI 1760969190) is a healthcare organization registered as a general practice in Mesa, Arizona and active in the NPI registry since July 2018. The organization lists Jonathan Harris, Pa-c/member Of Corporation, as its authorized official.

NPPES Registry Identity

NPI1760969190
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePROVIDER PROVIDER PC
Location Address841 W 11TH STMesa, AZ 85201-3109
Mailing Address841 W 11th StMesa, AZ 85201-3109
Phone(480) 461-9822
Organization SubpartNo
Authorized OfficialJonathan HarrisPa-c/member Of Corporation · (480) 461-9822
Enumeration DateJuly 28, 2018
Last NPPES UpdateDecember 20, 20182 updates tracked since enumeration
✔ NPI 1760969190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

841 W 11TH ST, Mesa, AZ 85201
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provider Provider PC's NPI number?

The NPI number for Provider Provider PC is 1760969190. It was assigned to this organization in the NPPES registry on July 28, 2018.

Where is Provider Provider PC located?

Provider Provider PC is located at 841 W 11th St, Mesa, AZ 85201. The listed phone number is (480) 461-9822.

What is Provider Provider PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Provider Provider PC was last updated on December 20, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.