Individual provider Active NPI

Jordon Elizabeth Stephens

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1538726104
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8139 Issued in AZ
Practice address
2207 E Soft Wind Dr
Phoenix, AZ 85024-8667
Phone
(480) 440-6731
NPI assigned
May 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 8139 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2207 E Soft Wind Dr
Phoenix, AZ 85024-8667

Mailing address

3124 Willow Creek Rd
Prescott, AZ 86301-6610
Phone (928) 445-7085

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
I20201023001381 AZ Practitioner - Physician Assistant 6002236460 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8139AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nextcare Arizona I JV LLC Multi-Specialty Current 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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1538726104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "928-445-7085",
            "fax_number": "928-445-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 E SOFT WIND DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850248667",
            "telephone_number": "480-440-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JORDON",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8139",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.