Individual provider Active NPI

Linda Jean Lieber, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1700420403
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP235666 Issued in AZ
Practice address
1255 W Baseline Rd Ste 138a
Mesa, AZ 85202-5821
Phone
(623) 776-3006
Fax
(602) 266-9025
NPI assigned
Nov 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 Practitioner 363LF0000X AP235666 AZ Primary

Addresses

Primary practice location

1255 W Baseline Rd Ste 138a
Mesa, AZ 85202-5821

Mailing address

3450 N 3Rd St
Phoenix, AZ 85012-2331
Phone (602) 351-6986

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
I20200414003980 AZ Practitioner - Nurse Practitioner 4183054182 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP235666AZMDFamily Nurse Practitioner

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
Southwest Behavioral Health CurrentSince Aug 1, 2022 Accepting new patients
Southwest Behavioral Health Services Inc Current Accepting new patients
Southwest Behavioral Health Services, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Southwest Behavioral Health PastSince Aug 28, 2022 Accepting new patients
Southwest Behavioral Health Services, Inc. PastSince Aug 28, 2022 Accepting new patients

Locations

1255 W Baseline Rd
Ste 138A
Mesa, AZ 85202
Phone (623) 776-3006

1255 W Baseline Rd
Mesa, AZ 85202
Phone (480) 820-5422

1255 W Baseline Rd
Ste 104
Mesa, AZ 85202
Phone (480) 820-5422

404 W Aero Dr
Payson, AZ 85541
Phone (928) 238-3024

3450 N 3rd St
Phoenix, AZ 85012
Phone (602) 257-9339

2042 N 35th Ave
Phoenix, AZ 85009
Phone (602) 233-0115

7600 E Florentine Rd
Ste 101
Prescott Valley, AZ 86314
Phone (928) 775-7088

7600 E Florentine Rd
Ste 201
Prescott Valley, AZ 86314
Phone (928) 775-7088

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Southwest Behavioral Health Services Inc 49 clinicians

Practice addresses (Care Compare)

1255 W Baseline Rd
Mesa, AZ 85202-5820
Phone (420) 820-5422

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1700420403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122331",
            "telephone_number": "602-351-6986",
            "fax_number": "602-266-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W BASELINE RD STE 138A",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025821",
            "telephone_number": "623-776-3006",
            "fax_number": "602-266-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBER",
        "first_name": "LINDA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP235666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.