Individual provider Active NPI

Jake Alan Freeman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1609316827
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP9942 Issued in AZ
Practice address
3001 N 33Rd Ave
Phoenix, AZ 85017-5202
Phone
(602) 353-0703
NPI assigned
Mar 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10014898 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP9942 AZ Primary

Addresses

Primary practice location

3001 N 33Rd Ave
Phoenix, AZ 85017-5202

Mailing address

2219 S Valle Verde
Mesa, AZ 85209-1530
Phone (602) 373-8717

Other practice location 1

1235 SE Division St Ste 201B
Portland, OR 97202-1099
Phone (971) 319-4411

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
I20170725002322 AZ Practitioner - Nurse Practitioner 4789954603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3001 N 33Rd Ave
Phoenix, AZ 85017-5202
Phone (602) 353-0703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10014898ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family & Children'S Service CurrentSince Jun 12, 2017 Accepting new patients
Jewish Family & Children'S Service CurrentSince Jun 12, 2017 Accepting new patients
Jewish Family & Children'S Service Past Accepting new patients

Locations

880 N Colorado St
Gilbert, AZ 85233
Phone (480) 820-0825

5701 W Talavi Blvd
Ste 180
Glendale, AZ 85306
Phone (623) 486-8082

1255 W Baseline Rd
Ste B258
Mesa, AZ 85202
Phone 4808200825 ext. 11110

1840 N 95th Ave
Ste 160
Phoenix, AZ 85037
Phone (623) 234-9811

2033 N 7th St
Phoenix, AZ 85006
Phone (602) 257-9314

3001 N 33rd Ave
Phoenix, AZ 85017
Phone (602) 353-0703

4747 N 7th St
Ste 100
Phoenix, AZ 85014
Phone (602) 279-7655

Interoperability endpoints

  • Direct secure messaging: jake.freemanpmhnp.p1@direct.cbridges.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1609316827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 S VALLE VERDE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091530",
            "telephone_number": "602-373-8717",
            "fax_number": "866-711-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 N 33RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175202",
            "telephone_number": "602-353-0703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 SE Division St Ste 201B",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972021099",
            "country_code": "US",
            "telephone_number": "971-319-4411",
            "fax_number": "866-711-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "JAKE",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-07",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10014898",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP9942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.