Jennifer Walters Anderson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

294260 Issued in AZ

Practice address

3707 E Southern Ave
Mesa, AZ 85206-2569

Phone

(480) 849-9201

Fax

(480) 374-4179

NPI assigned

Feb 14, 2023

Last updated

Feb 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, WA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thrive Psychiatry LLCGroup PAC ID 1759892516, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26465/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1114717501

  WA

  Medicare reassignment Care Compare group NPD Authorized official
• Community 43

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1477151546
  Medicare reassignment NPD
• Highland Medical Center, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1740583186
  NPD (past)

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1235836743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062569",
            "telephone_number": "480-849-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062569",
            "telephone_number": "480-849-9201",
            "fax_number": "480-374-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNIFER",
        "middle_name": "WALTERS",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN210429",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "294260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis Charles Anderson, PH.D.
• David Carlton Anderson, MD
• Emily Anderson, MS OTR/L
• Jeffrey E. Anderson, RPH
• Jennifer Anderson, ADULT PMHNP-BC
• Jonna O Anderson, NP
• Kelli Elizabeth Anderson, LMT, NDTR
• Kelly D Anderson
• Lauren Grace Anderson
• Lauren L Anderson, PA

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.