Active NPI
Jerome Flowers
- Addiction (Substance Use Disorder) Counselor
- Tempe, AZ
National Provider Identifier
1043957285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LASAC-15088
- Practice address
- 1330 W Auto Dr
Tempe, AZ 85284-1017 - Phone
- (480) 553-7153
- NPI assigned
- May 18, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LASAC-15088 | AZ | Primary |
Addresses
Primary practice location
1330 W Auto Dr
Tempe, AZ 85284-1017
Mailing address
1330 W Auto Dr
Tempe, AZ 85284-1017
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LASAC-15088 | Other | AZ | LASAC |
| 1841543345 | Medicaid | AZ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://azhhhsapp.ecwcloud.com/mobiledoc/jsp/webemr/login/newLogin.jsp#/mobiledoc/jsp/webemr/scheduling/resourceSchedule.jsp |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LASAC-15088 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664496000000",
"number": "1043957285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 W AUTO DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 W AUTO DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841017",
"telephone_number": "480-553-7153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLOWERS",
"first_name": "JEROME",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-18",
"last_updated": "2022-09-30",
"certification_date": "2022-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LASAC-15088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LASAC",
"identifier": "LASAC-15088",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1841543345",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://azhhhsapp.ecwcloud.com/mobiledoc/jsp/webemr/login/newLogin.jsp#/mobiledoc/jsp/webemr/scheduling/resourceSchedule.jsp",
"affiliation": "N",
"address_1": "1330 W Auto Dr",
"city": "Tempe",
"state": "AZ",
"country_code": "US",
"postal_code": "852841017",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.