Jodi Lynn Behm, PA-C
Individual provider Active NPI Physician Assistant · Winslow, AZ
NPI 1396015368 · NPPES record last updated Jan 9, 2012
Key facts
- NPI
- 1396015368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5066 (AZ)
- Practice address
- 620 Lee St
Winslow, AZ 86047-2435 - Phone
- (928) 289-2000
- NPI assigned
- Jan 9, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120322000402 | AZ | Practitioner - Physician Assistant | 7517127954 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5066 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nextcare Arizona I JV LLC | Current | Accepting new patients | |
| North Country Healthcare, Inc. | Past | Accepting new patients |
Locations
2080 W Southern Ave
Bldg A1
Apache Junction, AZ 85120
Phone (480) 985-0172
450 S Willard St
Ste 120
Cottonwood, AZ 86326
Phone (928) 634-2574
1000 N Humphreys St
Ste 104
Flagstaff, AZ 86001
Phone (928) 779-3844
914 N Scottsdale Rd
Ste 104
Tempe, AZ 85288
Phone (480) 776-1620
9525 E Old Spanish Trl
Ste 101
Tucson, AZ 85748
Phone (520) 731-3666
1394 W 16th St
Yuma, AZ 85364
Phone (928) 539-0055
Interoperability endpoints
- jodi.behm.p1@direct.nachci.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5066 | AZ | Yes |
Addresses
Primary practice location
620 Lee St
Winslow, AZ 86047-2435
Mailing address
620 Lee St
Winslow, AZ 86047-2435
Phone (928) 289-2000
Other providers in Winslow, AZ
- Rebecca Anne Barner
- Jayne Anne Barry
- Kathleen Bassani
- Charlene L Begay
- Sharon Rose Begay
- Prosper Sunil Bemunuge
- Joann Benally
- Davison J Benton
- Philana Nikita Betoney
- Subhash Chander Bhardwaj
All providers in Winslow, AZ · Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.