MS. JENNIFER RENEE DEPHILLIPS (NPI# 1316985823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316985823 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER RENEE DEPHILLIPS |
| Credential | PA-C |
| Practice Address |
77 W Forest Ave Ste 301 Flagstaff AZ 86001-1483 |
| Practice Telephone | 9287732280 |
| Mailing Telephone | 9287732280 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2016-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 3332 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
3332 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3332 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 977598 | 05 |
| Street Address |
77 W FOREST AVE STE 301 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073070603 | Daryl Finch | Specialist/Technologist | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2019-03-01 |
| 1790284131 | Sean Easton | Physician Assistant | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2018-02-11 |
| 1447775887 | Kelly Patterson | Physician Assistant | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2017-08-07 |
| 1861839219 | Julie A Degeyter | Physical Therapist | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2013-05-24 |
| 1639433048 | Ross Jones | Orthopaedic Surgery | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001 | 2012-06-29 |
| 1508123175 | Brianna Nicole Patti | Orthopaedic Surgery | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2012-04-19 |
| 1609190115 | Marshall Meier | Physical Medicine & Rehabilitation | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2010-03-26 |
| 1457589061 | Jennifer Marie Almendarez | Specialist | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2009-06-23 |
| 1518193382 | Derek Christopher Bontrager | Specialist/Technologist, Other | 77 W Forest Ave Ste 301, Flagstaff, AZ 86001-1483 | 2009-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962857383 | Kimberly J. Sargent Pa-c, Pllc | Physician Assistant | 711 W Aspen Ave, Flagstaff, AZ 86001-5301 | 2016-05-04 |
| 1972990851 | Joel Packard | Physician Assistant | 50 Pine Del Dr, Flagstaff, AZ 86005-9603 | 2015-04-18 |
| 1750349338 | Jennifer Michelle Morris | Physician Assistant | 31 E Conquistador Trl, Flagstaff, AZ 86001-8317 | 2006-05-03 |
| 1558849596 | Neurofit Health Pllc | Physician Assistant | 1200 N. Beaver, Flagstaff, AZ 86001-3118 | 2018-08-01 |
| 1558614834 | Gregory A. Cox, Pa-c, Pllc | Physician Assistant | 709 W Birch Ave, Flagstaff, AZ 86001-4417 | 2012-10-24 |
| 1871521690 | Thomas E Anderson | Physician Assistant | 1215 N Beaver St, Suite 203, Flagstaff, AZ 86001-3126 | 2006-06-29 |
| 1881651362 | Robert M Evans | Physician Assistant | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760030647 | Blaine Wesley Price | Physician Assistant | 796 W Jardin Dr, Casa Grande, AZ 85122-6162 | 2019-09-03 |
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1972166858 | Red Heart Surgical Assisting | Physician Assistant | 43643 W Arizona Ave, Maricopa, AZ 85138-5642 | 2019-04-17 |
| 1053898833 | Sportsmedicine Outreach Specialist | Physician Assistant | 13247 N 80th Pl, Scottsdale, AZ 85260-4903 | 2018-07-24 |
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| 1366955155 | Jennifer R Osborne | Physician Assistant | 100 S Eastern Dawn Ave, Tucson, AZ 85748-1708 | 2017-11-15 |
| 1669985198 | Jacki Nichols | Physician Assistant | 5055 N Rock Canyon Rd, Tucson, AZ 85750-6003 | 2017-11-06 |
| 1720597214 | Merieme Khamsi | Physician Assistant | 14674 W Mountain View Blvrd #210, Surprise, AZ 85374 | 2017-09-27 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.