Individual provider Active NPI

Lauren Taylor Jenkins

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1295502284
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10916 Issued in AZ
Practice address
4135 S Power Rd Ste 129
Mesa, AZ 85212-3627
Phone
(480) 751-3091
Fax
(480) 751-3095
NPI assigned
Dec 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 10916 AZ Primary

Addresses

Primary practice location

4135 S Power Rd Ste 129
Mesa, AZ 85212-3627

Mailing address

4135 S Power Rd Ste 129
Mesa, AZ 85212-3627
Phone (480) 751-3091

Other practice location 1

1109 E Zesta Ln
Gilbert, AZ 85297-1943
Phone (480) 512-9882

Other practice location 2

3336 E Chandler Heights Rd Ste 132
Gilbert, AZ 85298-4264
Phone (480) 988-4645

Other practice location 3

4365 E Pecos Rd
Gilbert, AZ 85295-7875
Phone (480) 840-9155

Other practice location 4

725 W Elliot Rd Ste 105
Gilbert, AZ 85233-5301
Phone (480) 963-6144

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
I20250116002281 AZ Practitioner - Physician Assistant 6406384536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sundance Medical Associates PLLC Past Accepting new patients
Healing Hearts Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1295502284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123627",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123627",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1109 E Zesta Ln",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852971943",
            "country_code": "US",
            "telephone_number": "480-512-9882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3336 E Chandler Heights Rd Ste 132",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852984264",
            "country_code": "US",
            "telephone_number": "480-988-4645",
            "fax_number": "480-988-4745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4365 E Pecos Rd",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852957875",
            "country_code": "US",
            "telephone_number": "480-840-9155",
            "fax_number": "480-840-9320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 W Elliot Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852335301",
            "country_code": "US",
            "telephone_number": "480-963-6144",
            "fax_number": "480-899-1404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "LAUREN",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.