Jamie Pemberton

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

268115 Issued in AZ

Practice address

14441 W McDowell Rd Ste B102
Goodyear, AZ 85395-2519

Phone

(480) 516-8037

NPI assigned

Oct 25, 2021

Last updated

Dec 21, 2021By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Bridges IncGroup PAC ID 2062699721, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: genhealth.jamiepemberton@148814.advancedmd-direct.com
• Direct secure messaging: jamie.pembertonnp.p1@direct.cbridges.nextgenshare.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.

• Community Bridges, Inc.

  dba CBI - Encompass Page Integrated Health Home

  • Adult Mental Health Clinic/Center
  • Page, AZ
  • NPI 1558095315
  Medicare reassignment Care Compare group NPD
• Community Bridges, Inc

  dba Lighthouse

  • Mental Illness Community Based Residential Treatment Facility
  • Yuma, AZ
  • NPI 1861722175
  NPD
• Community Bridges, Inc.

  dba Toole Outpatient Service Center

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1427596196
  NPD
• Community Bridges, Inc.

  dba Community Psychiatric Emergency Center - Outpatient

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1588348775
  NPD
• Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1508124488
  NPD (past)
• Genhealth

  • Psychiatry Physician
  • Goodyear, AZ
  • NPI 1144799792

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1487318515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N ESTRELLA PKWY # B2-204",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14441 W MCDOWELL RD STE B102",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952519",
            "telephone_number": "480-516-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "268115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hiroko Pearce
• Rodney Pearson, BS, MSPC, LPC, D.MIN
• Pebble Creek Medical Group PLLC
• Hailee Pedersen, OTR/L
• Daisy Pedrosa, MSN, APRN-RNP, PMHNP
• Blanca Olivia Pena, PA-C
• Chelsea Lane Penne, LMSW
• Meghan Elizabeth Pennock Lucchese
• Peoples Wellness LLC
• Dylan Perazzo, BS, RBT

• Psychiatric/Mental Health Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.
• 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.