Individual provider Active NPI

Jay Calvin Kempton

  • Family Medicine Physician
  • Show Low, AZ
National Provider Identifier
1972187466
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
250964 Issued in AZ
Practice address
5300 S Sutter Dr Ste a
Show Low, AZ 85901-8054
Phone
(928) 251-4244
Fax
(833) 539-1739
NPI assigned
May 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 250964 AZ Primary

Addresses

Primary practice location

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

Mailing address

1291 E Woolford Rd Lot B
Show Low, AZ 85901-7118
Phone (928) 322-4227

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Desktop

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
I20220810001132 AZ Practitioner - Nurse Practitioner 0244613164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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)

5300 S Sutter Dr
Unit a
Show Low, AZ 85901-8374
Phone (928) 251-4244

Hospital & facility affiliations

  • My Daughters Home Health Agency LLC Home health agency, Show Low, AZ, CCN 037837
  • Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250964AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Mountain Healthcare LLC CurrentSince Sep 8, 2023 Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

5300 S Sutter Dr
Unit A
Show Low, AZ 85901
Phone (928) 251-4244

Interoperability endpoints

  • Direct secure messaging: jay.kempton.1@24099.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1972187466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 E WOOLFORD RD LOT B",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017118",
            "telephone_number": "928-322-4227"
        },
        {
            "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",
            "fax_number": "833-539-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPTON",
        "first_name": "JAY",
        "middle_name": "CALVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "250964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "address_1": "1291 E Woolford Rd Lot B",
            "city": "Show Low",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "859017118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.