Individual provider Active NPI

Jessica Flittie, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1871956557
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8596 Issued in AZ
Practice address
4375 E Irma LN
Phoenix, AZ 85050-4312
Phone
(480) 890-5800
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN169321 AZ
Family Nurse Practitioner 363LF0000X AP8596 AZ Primary

Addresses

Primary practice location

4375 E Irma LN
Phoenix, AZ 85050-4312

Mailing address

4375 E Irma LN
Phoenix, AZ 85050-4312
Phone (480) 890-5800

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
I20160719001766 AZ Practitioner - Nurse Practitioner 9234422916 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
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

4375 E Irma LN
Phoenix, AZ 85050-4312
Phone (480) 890-5800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN169321AZMDRegistered Nurse First Assistant
AP8596AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients

Locations

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

1300 S Country Club Dr
Ste 3
Mesa, AZ 85210
Phone (480) 827-5500

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

4375 E Irma Ln
Phoenix, AZ 85050
Phone (480) 890-5800

Organizations & group practices 2

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1871956557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLITTIE",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "AZ",
            "license": "RN169321",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.