Jessie Lyn Stark, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

306183 Issued in AZ

Practice address

16430 W Yuma Rd
Goodyear, AZ 85338-3102

Phone

(623) 465-6405

NPI assigned

Jul 1, 2024

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1316349855
  Medicare reassignment NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1609229764
  Medicare reassignment NPD
• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Payson, AZ
  • NPI 1194369074
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • San Tan Valley, AZ
  • NPI 1942653019
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1962855031
  NPD

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1225873201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16430 W YUMA RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383102",
            "telephone_number": "623-465-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16430 W YUMA RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383102",
            "telephone_number": "623-465-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JESSIE",
        "middle_name": "LYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "306183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samyuktha Sreenivasan, M.D.
• Shreyesi Srivastava
• Brittany Standerfer, PHARMD
• Brent Richard Stanley, D.D.S
• Monique A Staples
• Dameon A Starks
• Starlink Services
• Tammi Starnes
• Ann Marie Stein, RDN
• Kevin Todd Stephan

• Family Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, 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 Jul 1, 2024; 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.