Jr Medical Group, PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JR MEDICAL GROUP, PLC

Doing business as

Cornerstone Family Medicine

Practice address

4545 E Southern Ave Ste 103
Mesa, AZ 85206-2677

Phone

(480) 981-6100

Fax

(480) 981-5501

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Kendra Thompson

Title

Director

Phone

(480) 981-6100

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Cornerstone Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1376664540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 E SOUTHERN AVE",
            "address_2": "SUITE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-981-6100",
            "fax_number": "480-981-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E SOUTHERN AVE STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062677",
            "telephone_number": "480-981-6100",
            "fax_number": "480-981-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JR MEDICAL GROUP, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-05-21",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-981-6100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "489254",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411863",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER #",
            "identifier": "080179242",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER ID #",
            "identifier": "080181881",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482323",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.