Jillian P Dohrn, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

218671 Issued in AZ

Practice address

5940 W Union Hills Dr Ste D100
Glendale, AZ 85308-1361

Phone

(602) 978-2500

Fax

(602) 938-2198

NPI assigned

Oct 25, 2018

Last updated

Oct 25, 2018By 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 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Cactus Childrens Clinic PC

  • Pediatrics Physician
  • Glendale, AZ
  • NPI 1891850145

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1295202596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 W UNION HILLS DR STE D100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081361",
            "telephone_number": "602-978-2500",
            "fax_number": "602-938-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 W UNION HILLS DR STE D100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081361",
            "telephone_number": "602-978-2500",
            "fax_number": "602-938-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHRN",
        "first_name": "JILLIAN",
        "middle_name": "P",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "218671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.