Individual provider Active NPI

Jessica Lynn Glentz, FNP-C

  • Family Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1508457086
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP253057 Issued in AZ
Practice address
2074 E Southern Ave Ste B101
Tempe, AZ 85282-7534
Phone
(480) 839-1032
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RNP253057 AZ Primary

Addresses

Primary practice location

2074 E Southern Ave Ste B101
Tempe, AZ 85282-7534

Mailing address

845 E Warner Rd Ste 103
Chandler, AZ 85225-1058
Phone (480) 839-4564

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
I20230802000061 AZ Practitioner - Nurse Practitioner 5294119798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chikwendu C Nwosu MD LLCGroup PAC ID 5698950178, 11 clinicians
Stripes Urgent Care LLCGroup PAC ID 4082913058, 7 clinicians

Practice addresses (Care Compare)

2919 S Ellsworth Rd
Suite 139
Mesa, AZ 85212-2168
Phone (480) 984-5225

6820 S Kings Ranch Rd
Suite 130
Gold Canyon, AZ 85118-2959
Phone (480) 246-3411

Hospital & facility affiliations

  • Cobre Valley Regional Medical Center Hospital, Globe, AZ, CCN 031314

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNP253057AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Medical Solutions Inc Single Specialty CurrentSince Mar 27, 2022 Accepting new patients
Chikwendu C Nwosu MD LLC Single Specialty CurrentSince Jun 5, 2023 Accepting new patients
Daniel Bauer MD PC Single Specialty PastSince Mar 27, 2022 Accepting new patients

Locations

750 S Ironwood Dr
Ste 101
Apache Junction, AZ 85120
Phone (480) 982-1265

845 E Warner Rd
Ste 103
Chandler, AZ 85225
Phone (480) 456-4500

6820 S Kings Ranch Rd
Ste 130
Gold Canyon, AZ 85118
Phone (480) 246-3411

2919 S Ellsworth Rd
Ste 139
Mesa, AZ 85212
Phone (480) 246-3411

2919 S Ellsworth Rd
Ste 101
Mesa, AZ 85212
Phone (480) 305-1000

2074 E Southern Ave
Ste B101
Tempe, AZ 85282
Phone (480) 839-1032

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1508457086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 E WARNER RD STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251058",
            "telephone_number": "480-839-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 E SOUTHERN AVE STE B101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827534",
            "telephone_number": "480-839-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENTZ",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP253057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.