Individual provider Active NPI

Jamie Linnea Richardson, FNP

  • Family Nurse Practitioner
  • Apache Junction, AZ
National Provider Identifier
1487257093
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
250091 Issued in AZ
Practice address
105 S Delaware Dr
Apache Junction, AZ 85120-6511
Phone
(480) 646-1001
NPI assigned
Nov 17, 2020
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 250091 AZ Primary

Addresses

Primary practice location

105 S Delaware Dr
Apache Junction, AZ 85120-6511

Mailing address

105 S Delaware Dr
Ste 2
Apache Junction, AZ 85120-6512
Phone (480) 646-1001

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Jrichardson@suncrestcare.com Direct

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
I20201130003126 AZ Practitioner - Nurse Practitioner 2264843069 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
250091AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC CurrentSince Jun 1, 2021 Accepting new patients
Leading Healthcare Clinic of Goodyear LLC Family CurrentSince May 19, 2024 Accepting new patients
Leading Healthcare, LLC Past Accepting new patients
Total Health Clinic LLC PastSince Nov 22, 2020 Accepting new patients

Locations

2440 S Ironwood Dr
Ste B
Apache Junction, AZ 85120

5620 W Thunderbird Rd
Ste C1
Glendale, AZ 85306
Phone (602) 843-1317

13555 W McDowell Rd
Ste 205
Goodyear, AZ 85395
Phone (623) 535-0740

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

3624 N Power Rd
Mesa, AZ 85215
Phone (480) 924-3797

8035 E Brown Rd
Mesa, AZ 85207
Phone (480) 686-8540

9230 E Main St
Mesa, AZ 85207
Phone (480) 380-0087

13203 N 103rd Ave
Ste I5
Sun City, AZ 85351

Interoperability endpoints

  • Direct secure messaging: jamie.richardson.1@19654.direct.athenahealth.com

Organizations & group practices 4

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": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1487257093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S DELAWARE DR",
            "address_2": "STE 2",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851206512",
            "telephone_number": "480-646-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S DELAWARE DR",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851206511",
            "telephone_number": "480-646-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JAMIE",
        "middle_name": "LINNEA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "250091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jrichardson@suncrestcare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4650 E Cotton Center Blvd Ste 250",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850404806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

Verify at the official NPI Registry.