Individual provider Active NPI

Jacqueline Colene Welker, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1962890434
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5424 E Southern Ave
Suite 101
Mesa, AZ 85206-3621
Phone
(480) 654-6200
Fax
(480) 654-6214
NPI assigned
Jan 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AZ Primary

Addresses

Primary practice location

5424 E Southern Ave
Suite 101
Mesa, AZ 85206-3621

Mailing address

5424 E Southern Ave
Suite 101
Mesa, AZ 85206-3621
Phone (480) 654-6200

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
I20150528002704 AZ Practitioner - Physician Assistant 9830419068 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth-Fastmed Ambulatory Holdings LLC CurrentSince Dec 1, 2020 Accepting new patients
Honorhealth-Fastmed Ambulatory Holdings LLC CurrentSince Dec 1, 2020 Accepting new patients
Tri-City Express Care, PLLC CurrentSince Apr 10, 2017 Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Whispering Palms Medical Inc Past Accepting new patients
Honorhealth Urgent Care, LLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients

Locations (25 of 30)

2875 W Ray Rd
Ste 8
Chandler, AZ 85224
Phone (480) 726-3440

4959 W Ray Rd
Ste 33
Chandler, AZ 85226
Phone (480) 214-2188

3705 S Arizona Ave
Ste 1
Chandler, AZ 85248
Phone (480) 214-7828

495 N Pinal Pkwy
Ste 106
Florence, AZ 85132
Phone (520) 568-0573

920 E Williams Field Rd
Ste 101
Gilbert, AZ 85295
Phone (480) 499-0201

890 W Elliot Rd
Ste 103
Gilbert, AZ 85233
Phone (480) 241-7564

3730 W Happy Valley Rd
Ste 100
Glendale, AZ 85310
Phone (623) 277-4140

1507 N Litchfield Rd
Ste 200
Goodyear, AZ 85395
Phone (623) 215-0040

1955 S Signal Butte Rd
Ste 103
Mesa, AZ 85209
Phone (480) 214-4466

415 N Val Vista Dr
Ste 101
Mesa, AZ 85213
Phone (480) 654-5661

835 W University Dr
Mesa, AZ 85201
Phone (480) 664-6007

1810 S Power Rd
Ste 101
Mesa, AZ 85206
Phone (480) 214-0045

2423 W Dunlap Ave
Ste 150
Phoenix, AZ 85021
Phone (602) 216-6862

3302 W Thomas Rd
Ste 10
Phoenix, AZ 85017
Phone (602) 233-2900

8260 W Indian School Rd
Ste 1
Phoenix, AZ 85033
Phone (623) 846-7122

5259 W Indian School Rd
Ste 100
Phoenix, AZ 85031
Phone (623) 888-5101

2301 N 44th St
Phoenix, AZ 85008
Phone (602) 808-8786

2860 W Peoria Ave
Ste B
Phoenix, AZ 85029
Phone (602) 283-0595

4902 E Shea Blvd
Ste 101
Scottsdale, AZ 85254
Phone (480) 214-4468

7730 E McDowell Rd
Ste 101
Scottsdale, AZ 85257
Phone (480) 699-3314

12775 W Bell Rd
Ste 100
Surprise, AZ 85378
Phone (623) 215-0082

1804 W Elliot Rd
Tempe, AZ 85284
Phone (480) 456-0444

940 E University Dr
Ste 101
Tempe, AZ 85288
Phone (480) 214-0622

2720 W Baseline Rd
Tempe, AZ 85283
Phone (602) 777-6000

3244 S Mill Ave
Ste 101
Tempe, AZ 85282
Phone (480) 214-0621

Organizations & group practices 12

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": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1962890434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 E SOUTHERN AVE",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063621",
            "telephone_number": "480-654-6200",
            "fax_number": "480-654-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 E SOUTHERN AVE",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063621",
            "telephone_number": "480-654-6200",
            "fax_number": "480-654-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELKER",
        "first_name": "JACQUELINE",
        "middle_name": "COLENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.