Active NPI
Jamie Kearney, NP
- Pediatric Nurse Practitioner
- Douglas, AZ
National Provider Identifier
1619413895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP7795
- Practice address
- 815 E 15TH St
Douglas, AZ 85607-1631 - Phone
- (520) 364-5437
- Fax
- (520) 364-4261
- NPI assigned
- Jan 12, 2017
- Last updated
- Oct 12, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP7795 | AZ | Primary |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | C-APN.0107485-C-NP | CO |
Addresses
Primary practice location
815 E 15TH St
Douglas, AZ 85607-1631
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Other practice location 1
13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234
Other practice location 2
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-4685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791763200000",
"number": "1619413895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 E 15TH ST",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856071631",
"telephone_number": "520-364-5437",
"fax_number": "520-364-4261"
}
],
"practiceLocations": [
{
"address_1": "13123 E 16th Ave",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800457106",
"country_code": "US",
"telephone_number": "720-777-1234",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1919 E Thomas Rd",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850167710",
"country_code": "US",
"telephone_number": "602-933-4685",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEARNEY",
"first_name": "JAMIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-12",
"last_updated": "2026-10-12",
"certification_date": "2026-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AZ",
"license": "AP7795",
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CO",
"license": "C-APN.0107485-C-NP",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Douglas, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.