Individual provider Active NPI

Jayden T Coburn

  • Acute Care Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1144173758
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
260854 Issued in AZ
Practice address
2158 N Gilbert Rd Ste 106
Mesa, AZ 85203-2109
Phone
(480) 690-5210
NPI assigned
Feb 16, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 260854 AZ Primary
Registered Nurse 163W00000X 260854 AZ

Addresses

Primary practice location

2158 N Gilbert Rd Ste 106
Mesa, AZ 85203-2109

Mailing address

2158 N Gilbert Rd Ste 106
Mesa, AZ 85203-2109
Phone (480) 690-5210

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260625002394 AZ Practitioner - Nurse Practitioner 6002389541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gilead Heart and Vascular PLLCGroup PAC ID 6800243940, 2 clinicians

Practice addresses (Care Compare)

750 S Ironwood Dr
Suite 103
Apache Junction, AZ 85120-5047
Phone (312) 772-8483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
260854AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gilead Heart and Vascular PLLC CurrentSince May 6, 2026 Accepting new patients

Locations

750 S Ironwood Dr
Apache Junction, AZ 85120
Phone (480) 982-1265

750 S Ironwood Dr
Ste 103
Apache Junction, AZ 85120
Phone (480) 674-3295

2158 N Gilbert Rd
Ste 106
Mesa, AZ 85203
Phone (312) 772-8483

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEEDDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEEDDD/Endpoint/AEEDDD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1144173758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 N GILBERT RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032109",
            "telephone_number": "480-690-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 N GILBERT RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032109",
            "telephone_number": "480-690-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "JAYDEN",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "260854",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "260854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.