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Active NPI 1154878072 Individual Practitioner Female Practitioner

Jerice Lake

Nurse Practitioner - Pediatrics • Mesa, AZ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jerice Lake is a certified Nurse Practitioner - Pediatrics practicing in Mesa, AZ. With approximately 5 years of clinical experience since completing medical education in 2021, Jerice Lake delivers high-quality medical care to the local community at 2343 W MAIN ST.

Jerice Lake is affiliated with Seattle Childrens Hospital and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

2343 W Main St
Apt. 2030

Mesa, AZ 852019003

Telephone 3406424597
Associated Practice Facility / Clinic
🏢 Riteway Medical Trans Llc Facility NPI 1235552449

Medicare Profile & Education

Medical School

Other

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Mesa, AZ

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs Matches City Avg
City Avg: 5.0 Yrs
State Avg: 11.9 Yrs
Regional Practice Density
28 Specialists

Practicing in Mesa, AZ (443 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lake (5 Years) 5 Yrs
Mesa Specialty Average (5.0 Years) 5.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2022-02-28
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License AZ 264646

Definition to come...

Registered Nurse

NUCC Taxonomy Code: 163W00000X

State License AZ RN198973

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Hospital & Practice Group Affiliations

Seattle Childrens Hospital

4800 Sand Point Way Ne, Seattle, WA 981053901

Phone: 2069872000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Katie Witchley

Specialist/Technologist - Speech-Language Assistant

NPI 1750738456

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address February 28, 2022

Registered at 400 N CORONADO ST APT 3010, CHANDLER, AZ 852243207

NPI Profile Active September 08, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 08, 2016

Registered at 2343 W MAIN ST, APT. 2030, MESA, AZ 852019003 (Tel: 3406424597)

📍
Updated Business Mailing Address September 08, 2016

Registered at 2343 W MAIN ST, APT. 2030, MESA, AZ 852019003

👤
Provider Name / Credentials Updated September 08, 2016

Recorded as JERICE LAKE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2016

Registered Nurse (License #RN198973 in AZ)

🟢
Initial NPI Registration & Enumeration September 08, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154878072
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 08, 2016
Last Update: February 28, 2022
Sole Proprietor: Yes

Mailing Address

400 N Coronado St Apt 3010

Chandler, AZ 852243207

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.