Jennyfer Nayeli Willford, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11673 Issued in AZ

Practice address

616 E Southern Ave Ste 103
Mesa, AZ 85204-4941

Phone

(602) 569-3999

Fax

(602) 569-3887

NPI assigned

Aug 24, 2018

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

Other names 1

• Prof. Jennyfer Sandoval Willford Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinica la Familia, PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1780668921

  Multi-Specialty

  Medicare reassignment NPD
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1407337785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 E WILLETTA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062935",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E SOUTHERN AVE STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852044941",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Cottonwood Ln Ste 1&2",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851222551",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1315 W Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852824519",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "616 E Southern Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852044941",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLFORD",
        "first_name": "JENNYFER",
        "middle_name": "NAYELI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNYFER",
            "last_name": "SANDOVAL WILLFORD",
            "prefix": "PROF.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Willard, LAC
• Halle Willden
• Jeffery D Willden, DO
• Larisa Willden, FNP-C
• Susan Willever, N.P.
• Mihrage Anne Willhauck, NMD
• William E. Deyden, M.D, P.C
• William Kentopp and John J Bodine (Succeed Physical Therapy & Wellness)
• William Wagner MD PC
• Patricia Williams-Shelman, RBT

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.