Jordan Riley Jensen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5295 Issued in AZ

Practice address

645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351

Phone

(480) 500-2540

Fax

(623) 201-7954

NPI assigned

Oct 31, 2012

Last updated

Nov 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lanika Gwynae Scepurek Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Agave Solutions PLLC

  • Psychiatry Physician
  • Avondale, AZ
  • NPI 1619594546
  Medicare reassignment
• 4C Medical Group PLC

  dba 4C Urgent Care

  • Urgent Care Clinic/Center
  • Carefree, AZ
  • NPI 1669916607
  NPD (past)
• U2Rworthit1 LLC

  • Primary Care Nurse Practitioner
  • Tucson, AZ
  • NPI 1265187900
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574899200000",
    "number": "1023362910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "320-360-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "480-500-2540",
            "fax_number": "623-201-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JORDAN",
        "middle_name": "RILEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2019-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANIKA",
            "last_name": "SCEPUREK",
            "middle_name": "GWYNAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elliot Jensen, DO
• Hannah Jensen
• Jacquelyn Beth Jensen, MSW, LISAC
• Jason Warner Jensen, N.M.D.
• Jenna Jensen
• Kate Nicole Jensen, MD
• Kristen Ann Jensen, PA-C
• Margaret Jensen, RNFA
• Matthew T Jensen, DDS
• Melissa Jensen

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.