| Jr Medical Group, Plc | |
|
4545 E Southern Ave Ste 103 Mesa AZ 85206-2677 | |
| (480) 981-6100 | |
| (480) 981-5501 |
| Full Name | Jr Medical Group, Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 4545 E Southern Ave Ste 103, Mesa, Arizona |
| Authorized Official Name and Position | Kendra Thompson (DIRECTOR) |
| Authorized Official Contact | 4809816100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jr Medical Group, Plc 4545 E Southern Ave Suite 103 Mesa AZ 85206 Ph: (480) 981-6100 | Jr Medical Group, Plc 4545 E Southern Ave Ste 103 Mesa AZ 85206-2677 Ph: (480) 981-6100 |
| NPI Number | 1376664540 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 8921082223 |
|---|---|
| Medicare Enrollment ID | O20040615000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376664540 | NPI | - | NPPES |
| 489254 | Medicaid | AZ | |
| 411863 | Medicaid | AZ | |
| 080179242 | Other | AZ | RAILROAD MEDICARE PROVIDER # |
| 080181881 | Other | AZ | RAILROAD MEDICARE PROVIDER ID # |
| 482323 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brett E Willden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174515134 PECOS PAC ID: 9830082510 Enrollment ID: I20040206000836 |
| Provider Name | Jeffery Dick Willden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831243294 PECOS PAC ID: 4587604020 Enrollment ID: I20050513000637 |
| Provider Name | Rustin W Crawford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659419091 PECOS PAC ID: 2961539358 Enrollment ID: I20100415000743 |
| Provider Name | Mary J Bootz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851842447 PECOS PAC ID: 5890076012 Enrollment ID: I20161230001701 |
| Provider Name | Jenny Haag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649628280 PECOS PAC ID: 3072806793 Enrollment ID: I20170504001270 |
| Provider Name | Fiona I Henderson Power |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902326937 PECOS PAC ID: 8921370297 Enrollment ID: I20170821003233 |
| Provider Name | Mary Clouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982128351 PECOS PAC ID: 1456627611 Enrollment ID: I20171017000508 |
| Provider Name | David Cresap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457863334 PECOS PAC ID: 1456618990 Enrollment ID: I20171207003399 |
| Provider Name | Bianca P Garcia Kendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578074134 PECOS PAC ID: 3476885088 Enrollment ID: I20191031002536 |
| Provider Name | Rachel Margaret Greatwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912431800 PECOS PAC ID: 9739512534 Enrollment ID: I20210713000462 |
| Provider Name | Samuel Adrian Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649972431 PECOS PAC ID: 1456725795 Enrollment ID: I20230328000923 |
| Provider Name | Sara Margaret Johansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821672601 PECOS PAC ID: 6709246184 Enrollment ID: I20230717002647 |
Ohana Kids & Family Kare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3130 E Baseline Rd Ste 103, Mesa, AZ 85204 Phone: 480-539-7618 Fax: 480-900-8884 | |
True Patriot Consulting, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1134 E University Dr Ste 111, Mesa, AZ 85203 Phone: 480-398-1220 Fax: 480-398-1238 | |
M.g.t Rn Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7117 E Peralta Cir, Mesa, AZ 85212 Phone: 480-430-0721 | |
Stillpoint Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2266 S Dobson Rd Ste 200, Mesa, AZ 85202 Phone: 480-280-1996 Fax: 602-532-7649 | |
Voyage Medical Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1130 W Grove Ave Ste 115, Mesa, AZ 85210 Phone: 480-685-0930 | |
Tripp Family Medicine, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2830 E Brown Rd, Suite 1, Mesa, AZ 85213 Phone: 480-830-7546 Fax: 480-830-7550 | |
Michael J. Lucherini Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6828 E Brown Rd Ste 102, Mesa, AZ 85207 Phone: 480-981-8650 Fax: 480-981-1563 |