Mary Jane Wild Sorenson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11648 Issued in AZ

Practice address

5300 S Sutter Dr Ste a
Show Low, AZ 85901-8054

Phone

(928) 251-4244

NPI assigned

Aug 9, 2018

Last updated

Feb 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Mountain Healthcare LLCGroup PAC ID 4486058930, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Home Health Safford, LLC Home health agency, Safford, AZ, CCN 037815
• Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryjane.sorenson.1@24099.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Mountain Healthcare LLC

  • Adult Medicine Physician
  • Show Low, AZ
  • NPI 1881261857
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Home Health Safford, LLC

  dba Choice Health at Home

  • Home Health Agency
  • Safford, AZ
  • NPI 1154915015
  Care Compare affiliation
• Summit Healthcare Association

  dba Summit Healthcare Oncology Center

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  dba Summit Healthcare Regional Medical Center

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  Care Compare affiliation
• Summit Healthcare Medical Associates

  dba Family Medicine at Bison Ranch

  • Rural Health Clinic/Center
  • Overgaard, AZ
  • NPI 1770700767

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1851870919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 N SPRINGER MOUNTAIN DR",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859296617",
            "telephone_number": "520-730-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 S SUTTER DR STE A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859018054",
            "telephone_number": "928-251-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "MARY JANE",
        "middle_name": "WILD",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Sean Smithson, MD
• Snoozers Inc
• Michael J Snow, DDS
• Sober Mountain LLC
• Solstice Pediatrics and Sports Medicine, PLC
• Maria-Luz Sotomayor, NP
• Melinda J South
• Southern Girl Anesthesia Services Inc
• Southwestern Eye Center (Southwestern Eye Surgicenter-Show Low)
• Southwestern Home Health Care, Inc.

• Family Nurse Practitioner in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.