Jeanette Ladanga Ly, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11601 Issued in AZ

Practice address

2451 E Baseline Rd Ste 100
Gilbert, AZ 85234-2467

Phone

(480) 304-5152

Fax

(480) 603-4147

NPI assigned

Sep 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeanette Villanueva Ladanga Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1215411590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9647 E SHARON DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604495",
            "telephone_number": "702-985-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD STE 100",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342467",
            "telephone_number": "480-304-5152",
            "fax_number": "480-603-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "JEANETTE",
        "middle_name": "LADANGA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "LADANGA",
            "middle_name": "VILLANUEVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter M Lux, M.D.
• Luxe Healthcare Solutions LLC
• Luxottica of America Inc
• Luxottica of America Inc.
• LXV Biologics
• Nichole Rayleen Lynch, LMSW-21761
• Diana Lynn, RBT
• Katie Lynn, MS, RD
• Jesse Thomas Lyon, PA
• Katie Lyon

• Family Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.