Jessica Etchells, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6588 Issued in AZ

Practice address

7010 E Chauncey LN
Phoenix, AZ 85054

Phone

(480) 585-5200

NPI assigned

Nov 8, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jessica.etchells@agave.eclinicaldirectplus.com

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.

• Scottsdale Pediatrics and Pediatric Nephrology, PLLC

  dba Agave Pediatrics

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1629076518
  NPD (past)

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1386186351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 E CHAUNCEY LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 E CHAUNCEY LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "480-585-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETCHELLS",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rose Esty
• Kristi Etchechury, COTA/L
• Eternal Hope Therapy Services LLC
• Eternal Love Hospice LLC
• Eternal Pathway LLC
• Eternity Home Health Care LLC (Eternity Home Health Care)
• Eternity Hospice and Palliative Care, PLLC

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.