Individual provider Active NPI

Jessica Glover, FNP-C

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1124545835
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP10342 Issued in AZ
Practice address
1118 W Lynwood St
Phoenix, AZ 85007-1917
Phone
(602) 486-4271
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP10342 AZ Primary

Addresses

Primary practice location

1118 W Lynwood St
Phoenix, AZ 85007-1917

Mailing address

1118 W Lynwood St
Phoenix, AZ 85007-1917
Phone (602) 486-4271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20171120003493 AZ Practitioner - Nurse Practitioner 8628335072 Reassigns benefits to 2 organizations
I20200526000117 TX Practitioner - Nurse Practitioner 8628335072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Em-I Medical Services PCGroup PAC ID 8325034812, 23 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (954) 939-5000

Hospital & facility affiliations

  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10342AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Oct 1, 2021 Accepting new patients
303 Emergency Physicians PLLC Nurse Practitioner CurrentSince Jul 3, 2020 Accepting new patients
Arizona Em-I Medical Services PC Nurse Practitioner CurrentSince Nov 7, 2023 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Oct 1, 2021 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Mar 1, 2020 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Mar 1, 2020 Accepting new patients
Yuma Regional Medical Center Past Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

33423 N 32nd Ave
Phoenix, AZ 85085
Phone (623) 474-1600

520 Rose Ln
Wickenburg, AZ 85390
Phone (928) 666-1197

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1124545835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 W LYNWOOD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850071917",
            "telephone_number": "602-486-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 W LYNWOOD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850071917",
            "telephone_number": "602-486-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.