Jenna Brooke Prewitt, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5351 Issued in AZ

Practice address

1950 S Country Club Dr Ste 101
Mesa, AZ 85210-6044

Phone

(480) 827-5500

NPI assigned

Feb 28, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jenna Brooke Kaitz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1174863112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8408 E SAGE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852506740",
            "telephone_number": "480-827-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 S COUNTRY CLUB DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106044",
            "telephone_number": "480-827-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREWITT",
        "first_name": "JENNA",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "5351",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "KAITZ",
            "middle_name": "BROOKE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Isadora Preston-Jones, RN
• Emma Catherine Preston
• Shea Prestwich, PA-C
• Carol Preuitt, LISAC
• Mackenzie Elizabeth Prew
• Chelsea M Price, MS, RD, LDN
• Ginger L Price, D.D.S.
• Jaree Price
• Mariel Price, RN. MSN, FNP-BC
• McKenna Faye Price, BCBA

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.