Individual provider Active NPI

Jamie Lynn Mainville, FNP

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1164025920
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
250087 Issued in AZ
Practice address
428 S Gilbert Rd Ste 101
Gilbert, AZ 85296-2261
Phone
(480) 677-8282
Fax
(844) 470-2777
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 250087 AZ Primary

Addresses

Primary practice location

428 S Gilbert Rd Ste 101
Gilbert, AZ 85296-2261

Mailing address

261 N Roosevelt Ave
Chandler, AZ 85226-2617
Phone (480) 677-8282

Other identifiers 1

IdentifierTypeStateIssuer
088939MedicaidAZ

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
I20210223000961 AZ Practitioner - Nurse Practitioner 0840605986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Health Medical PLLCGroup PAC ID 3779680962, 215 clinicians

Practice addresses (Care Compare)

428 S Gilbert Rd
Suite 101
Gilbert, AZ 85296-2261
Phone (480) 677-8282

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC CurrentSince Jun 8, 2023 Accepting new patients
Good Health Medical, PLLC Current Accepting new patients
Good Health Medical, PLLC CurrentSince Jun 8, 2023 Accepting new patients
Livn, P.C. Past Accepting new patients
Good Health Medical, PLLC Past Accepting new patients

Locations

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

44360 W Edison Rd
Ste 135
Maricopa, AZ 85138

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

8260 N Cortaro Rd
Ste 152
Tucson, AZ 85743

Interoperability endpoints

  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

Organizations & group practices 5

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1164025920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-677-8282",
            "fax_number": "888-316-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 S GILBERT RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962261",
            "telephone_number": "480-677-8282",
            "fax_number": "844-470-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINVILLE",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "250087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088939",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.