HEATHER DIANE HARGRAVE (NPI# 1215404652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215404652 |
| Entity Type | Individual |
| Full Name | HEATHER DIANE HARGRAVE |
| Credential | PA-S |
| Practice Address |
635 E Baseline Rd Phoenix AZ 85042 |
| Mailing Address |
635 E Baseline Rd Phoenix AZ 85042-6551 |
| Practice Telephone | 6022437277 |
| Mailing Telephone | 6022437277 |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2019-09-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
7586 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861974008 | Heather Leigh Hargrave | Dietitian, Registered | 2800 N 23rd St Apt 2021, Broken Arrow, OK 74014-2044 | 2018-09-04 |
| Street Address |
635 E BASELINE RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164414892 | Neil Trachtenberg | Obstetrics & Gynecology | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2005-08-18 |
| 1548884240 | Heather E Weninger | Dietitian, Registered | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2020-05-29 |
| 1245863786 | Katherine Marie Bear | Nurse Practitioner | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2020-02-12 |
| 1841821642 | Manyil Dashe | Dietitian, Registered | 635 E Baseline Rd, Phoenix, AZ 85042-6583 | 2020-01-30 |
| 1962045112 | Natasha Burrell | Dietitian, Registered | 635 E Baseline Rd, Phoenix, AZ 85042-6583 | 2019-10-21 |
| 1700351475 | Robert Eugene Carter | Dietitian, Registered | 635 E Baseline Rd, Phoenix, AZ 85042-6583 | 2018-10-09 |
| 1134605132 | Philsy Jaison | Nurse Practitioner | 635 E Baseline Rd, Phoenix, AZ 85042-6583 | 2018-07-13 |
| 1891208948 | Samantha Thompson | Pharmacist | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2017-11-12 |
| 1295259075 | Evelyn Coronado | Dietitian, Registered | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2017-08-02 |
| 1376065904 | Vesna Babanovska | Dietitian, Registered | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2017-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443197 | Da Homes LLC | Case Management | 8026 S. 24th Way, Phoenix, AZ 85042 | 2020-10-05 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1427538362 | Abigail Mcgrath | Dietitian, Registered | 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 | 2018-08-20 |
| 1174028310 | Olufemi A Omodara | Pharmacist | 7227 S. Central Ave, #1080, Phoenix, AZ 85042 | 2018-03-29 |
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1922490382 | Brian Zembower | Optometrist | 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 | 2015-02-23 |
| 1417299819 | Robert Murphy Portley | Psychiatry & Neurology | 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 | 2013-03-23 |
| 1972807998 | Obinna Chukwuka Akubukwe | Pharmacist | 6006 S. Central Avenue, Phoenix, AZ 85042 | 2011-01-05 |
| 1104120328 | Gisheys Patient Care LLC | Custodial Care Facility | 7232 South 12th Place, Phoeniz, AZ 85042 | 2011-01-03 |
| 1245463488 | Lois Ann Hammitt | Registered Nurse | 6218 S. 7th Street, Phoenix, AZ 85042 | 2009-09-03 |
| Find all providers in zip 85042 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1659848208 | Pacific Dental Services Foundation | Physician Assistant | 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 | 2018-10-31 |
| 1124502372 | Amanda Rose Jones | Physician Assistant | 36427 N 14th St, Phoenix, AZ 85086-7506 | 2018-09-23 |
| 1639681745 | Martha Lopez | Physician Assistant | 7010 E Chauncey Ln Ste 210, Phoenix, AZ 85054-3115 | 2017-10-30 |
| 1386153674 | Emily Meredith Eoff | Physician Assistant | 301 W Pasadena Ave Apt 4, Phoenix, AZ 85013-2342 | 2017-09-29 |
| 1659890754 | Greg Horn | Physician Assistant | 20333 N 19th Ave Ste 230, Phoenix, AZ 85027-9901 | 2017-09-11 |
| 1619407269 | Integrative Natural Medicine | Physician Assistant | 2025 E Campbell Ave, #259, Phoenix, AZ 85016-8501 | 2017-06-15 |
| 1174996870 | Jyoti Sharma | Physician Assistant | 13838 S 46th Pl Ste 120, Phoenix, AZ 85044-7801 | 2015-11-04 |
| 1487025086 | Shaye Harrel | Physician Assistant | 9305 W Thomas Rd Ste 478, Phoenix, AZ 85037-3375 | 2015-10-08 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.