Tyeasa Renae Jones, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

238907 Issued in AZ

Practice address

41704 W Smith Enke Rd Ste 100
Maricopa, AZ 85138-2710

Phone

(623) 200-3526

Fax

(623) 401-6598

NPI assigned

Mar 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, AZ2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24354/brand/1/csg/1/fhir/r4

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.

• Way Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Maricopa, AZ
  • NPI 1720773534
  Medicare reassignment NPD Authorized official
• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  dba Oregon State Hospital (Salem)

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• Springview Counseling Inc

  • Counselor
  • Maricopa, AZ
  • NPI 1922679810
  NPD
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027
  NPD

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1053947945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41704 W SMITH ENKE RD STE 100",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851382710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41704 W SMITH ENKE RD STE 100",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851382710",
            "telephone_number": "623-200-3526",
            "fax_number": "623-401-6598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 NE 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322003",
            "country_code": "US",
            "telephone_number": "503-944-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "TYEASA",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202202599NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "238907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichelle Rynette Johnson, LPN
• Joint Healing Operations Alpha House LLC
• Joint Healing Operations Alpha House LLC (Mission Support Residences LLC)
• Danielle Josephine Jones, LPN
• Dwyla Dean Jones
• Olajumoke Omolola Jongbo, PMHNP
• Taylor L Jump, DPT
• Megan Eileen Kahler, LPN
• Karen Kramarczyk DDS Family Dentistry of Maricopa
• Meena A Kasisa, DMD

• Psychiatric/Mental Health Nurse Practitioner in Maricopa, AZ
• Providers in Maricopa, 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 Nov 4, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.