Individual provider Active NPI

Joann Eastman, FNP-BC

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1881044147
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8759 Issued in AZ
Practice address
1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone
(480) 610-7100
NPI assigned
Jun 17, 2016
Sex
Female
Sole proprietor
No

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60911805 WA
Family Nurse Practitioner 363LF0000X AP60911805 AZ
Family Nurse Practitioner 363LF0000X AP8759 AZ Primary

Addresses

Primary practice location

1917 S Crismon Rd
Mesa, AZ 85209-6216

Mailing address

1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone (480) 610-7100

Other identifiers 4

IdentifierTypeStateIssuer
RN090351OtherAZREGISTERED NURSE
AP60911805OtherWAADVANCED REGISTERED NURSE PRACTITIONER LICENSE
RN60896196OtherWAREGISTERED NURSE LICENSE
AP8759OtherAZADVANCED REGISTERED NURSE PRACTIONER

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
I20160913002391 AZ Practitioner - Nurse Practitioner 3274779574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone (480) 610-7100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60911805AZMDFamily Nurse Practitioner
AP8759AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Physician Practices, LLC CurrentSince Jul 10, 2017 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 21, 2023 Accepting new patients
Valley View Physician Practices LLC CurrentSince Jul 10, 2017 Accepting new patients
Valley View Physician Practices LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 21, 2023 Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients

Locations

5300 S Highway 95
Ste C
Fort Mohave, AZ 86426
Phone (928) 768-2330

1917 S Crismon Rd
Mesa, AZ 85209
Phone (480) 610-7100

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

Organizations & group practices 7

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1881044147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096216",
            "telephone_number": "480-610-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096216",
            "telephone_number": "480-610-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "JOANN",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60911805",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP60911805",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN090351",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED REGISTERED NURSE PRACTITIONER LICENSE",
            "identifier": "AP60911805",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "RN60896196",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED REGISTERED NURSE PRACTIONER",
            "identifier": "AP8759",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.