Jessica L Dery, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP4653 Issued in AZ

Practice address

1206 E Warner Rd Ste 101D
Gilbert, AZ 85296-3133

Phone

(480) 220-5864

Fax

(480) 324-2463

NPI assigned

Sep 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Answers Within PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
  • NPI 1679432140
  NPD Authorized official
• Answers Within PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gilbert, AZ
  • NPI 1427973668
  NPD (past) Authorized official
• Guardians of the Four Corners LLC

  • Mental Illness Community Based Residential Treatment Facility
  • San Tan Valley, AZ
  • NPI 1588380117
  NPD (past) Authorized official

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1043561624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S NEELY ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335830",
            "telephone_number": "480-361-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E WARNER RD STE 101D",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963133",
            "telephone_number": "480-220-5864",
            "fax_number": "480-324-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERY",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.