Individual provider Active NPI

Jessica Lynn Moran, FNP-CB

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1245056167
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN124127 Issued in AZ
Practice address
725 S Dobson Rd Ste 100
Chandler, AZ 85224-5676
Phone
(602) 795-8700
Fax
(602) 795-8701
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 RN124127 AZ Primary

Addresses

Primary practice location

725 S Dobson Rd Ste 100
Chandler, AZ 85224-5676

Mailing address

20280 N 59TH Ave Ste 115-617
Glendale, AZ 85308-6850
Phone (602) 795-8710

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
I20250815004516 AZ Practitioner - Nurse Practitioner 5193224244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Spine and Pain Specialists LLCGroup PAC ID 7214251396, 23 clinicians

Practice addresses (Care Compare)

725 S Dobson Rd
Suite 100
Chandler, AZ 85224-5676
Phone (602) 795-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN124127AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Spine and Pain Specialists LLC CurrentSince Jul 23, 2025 Accepting new patients
Arizona Spine and Pain Specialists LLC CurrentSince Jul 23, 2025 Accepting new patients

Locations

725 S Dobson Rd
Ste 100
Chandler, AZ 85224
Phone (480) 814-0266

20280 N 59th Ave
Ste 115610
Glendale, AZ 85308

7200 W Bell Rd
Ste F101
Glendale, AZ 85308
Phone (623) 776-9111

20280 N 59th Ave
Ste 115617
Glendale, AZ 85308

Organizations & group practices 2

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1245056167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20280 N 59TH AVE STE 115-617",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086850",
            "telephone_number": "602-795-8710",
            "fax_number": "602-795-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S DOBSON RD STE 100",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245676",
            "telephone_number": "602-795-8700",
            "fax_number": "602-795-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "FNP-CB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN124127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.