Active NPI
Jacqueline Virginia Mooney
- Physician Assistant
- Globe, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9439
- Practice address
- 5880 S Hospital Dr
Globe, AZ 85501-9447 - Phone
- (928) 425-3261
- Fax
- (928) 425-3859
- NPI assigned
- Dec 1, 2021
- Last updated
- Oct 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9439 | AZ | Primary |
Addresses
Primary practice location
5880 S Hospital Dr
Globe, AZ 85501-9447
Mailing address
5880 North Hospital Drive
Globe, AZ 85501
Phone (928) 425-3261
Other practice location 1
122 E 1700 S
Building 3
Provo, Utah 84606
Phone (801) 375-5125
Other practice location 2
9574 E 106th St
Fishers, IN 46037-9701
Phone (317) 999-3281
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (928) 425-3247
5990 S Hospital Dr
Globe, AZ 85501-9462
Phone (928) 425-8151
5994 S Hospital Dr
Globe, AZ 85501-9462
Phone (928) 425-7108
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9439 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cobre Valley Regional Medical Center | Current | Accepting new patients | |
| Cobre Valley Regional Medical Center | Current | Accepting new patients | |
| Cobre Valley Regional Medical Center | Current | Accepting new patients | |
| Rocky Mountain University of Health Professions Foundation | Past | Accepting new patients | |
| Cobre Valley Regional Medical Center | Past | Accepting new patients | |
| Rocky Mountain University Health Center | Past | Accepting new patients |
Locations
5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217
5990 S Hospital Dr
Globe, AZ 85501
Phone (520) 402-9319
5994 S Hospital Dr
Globe, AZ 85501
Phone (928) 425-7108
1134 W US Highway 60
Superior, AZ 85173
Phone (520) 689-2423
Organizations & group practices 6
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.
-
- Critical Access Hospital
- Globe, AZ
- NPI 1871566521
-
- Community/Retail Pharmacy
- Globe, AZ
- NPI 1639384233
-
dba Superior Clinic
- Rural Health Clinic/Center
- Superior, AZ
- NPI 1649245135
-
dba Cobre Valley Tonto Basin Clinic
- Rural Health Clinic/Center
- Tonto Basin, AZ
- NPI 1144799677
-
- Optometrist
- SLC, UT
- NPI 1861141822
-
- Physical Therapist
- Provo, UT
- NPI 1053174417
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Mesa, AZ
- NPI 1396497889
-
dba Cobre Valley Regional Medical Center Kearny Ambulance
- Ambulance
- Kearny, AZ
- NPI 1245824747
Hospital
-
- Critical Access Hospital
- Globe, AZ
- NPI 1871566521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1245998772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5880 NORTH HOSPITAL DRIVE",
"city": "GLOBE",
"state": "AZ",
"postal_code": "85501",
"telephone_number": "928-425-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5880 S HOSPITAL DR",
"city": "GLOBE",
"state": "AZ",
"postal_code": "855019447",
"telephone_number": "928-425-3261",
"fax_number": "928-425-3859"
}
],
"practiceLocations": [
{
"address_1": "122 E 1700 S",
"address_2": "Building 3",
"address_purpose": "LOCATION",
"city": "Provo",
"state": "Utah",
"postal_code": "84606",
"country_code": "US",
"telephone_number": "801-375-5125",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9574 E 106th St",
"address_purpose": "LOCATION",
"city": "Fishers",
"state": "IN",
"postal_code": "460379701",
"country_code": "US",
"telephone_number": "317-999-3281",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOONEY",
"first_name": "JACQUELINE",
"middle_name": "VIRGINIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-01",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "9439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Globe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.
- 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.