Organization Active NPI

Thrive Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1114717501
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
THRIVE PSYCHIATRY LLC
Practice address
3707 E Southern Ave
Mesa, AZ 85206-2569
Phone
(480) 849-9201
NPI assigned
May 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Jennifer AndersonNPI 1235836743
Title
Owner/Authorized Official
Phone
(480) 228-0339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3707 E Southern Ave
Mesa, AZ 85206-2569

Mailing address

3707 E Southern Ave
Mesa, AZ 85206-2569
Phone (480) 849-9201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250618000801 AZ Part B Supplier - Clinic/Group Practice 1759892516 Receives reassigned benefits from 2 practitioners
Practice locations: Mesa, AZ
O20250708001786 WA Part B Supplier - Clinic/Group Practice 1759892516 Receives reassigned benefits from 1 practitioner
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

701 NE 136th Ave
Vancouver, WA 98684
Phone (480) 228-0339

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1114717501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062569",
            "telephone_number": "480-849-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062569",
            "telephone_number": "480-849-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-228-0339"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.