Individual provider Active NPI

Jovy Avila

  • Assisted Living Facility
  • Mesa, AZ
National Provider Identifier
1740852391
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11272H Issued in AZ
Practice address
3759 E Clovis Ave
Mesa, AZ 85206-1841
Phone
(480) 597-3303
Fax
(480) 597-3303
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11272H AZ Primary

Addresses

Primary practice location

3759 E Clovis Ave
Mesa, AZ 85206-1841

Mailing address

1255 N Arizona Ave Unit 1365
Chandler, AZ 85225-0716
Phone (480) 646-2772

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL MESA Direct
CONNECT URL MESA Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL11272HAZMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Serenity Assisted Living Home LLC Assisted Living Facility CurrentSince May 19, 2024 Accepting new patients

Locations

3759 E Clovis Ave
Mesa, AZ 85206
Phone (480) 325-3890

Organizations & group practices 1

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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1740852391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N ARIZONA AVE UNIT 1365",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852250716",
            "telephone_number": "480-646-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3759 E CLOVIS AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061841",
            "telephone_number": "480-597-3303",
            "fax_number": "480-597-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "JOVY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL11272H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MESA",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3759 E Clovis Ave",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852061841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MESA",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3759 E Clovis Ave",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852061841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.