Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Taravine

Individual provider Durable Medical Equipment & Medical Supplies · NPI 1811770910

Jackson Taravine is a Physician Assistant in Surprise, Arizona. Qualified in 2023, 3 years ago. Practices with Afc of Surprise, PLLC, a 12-clinician group, works from 9 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
3
Licensed in
AZ
In the registry since
2023
Specialties on file
10
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Practice location Address checks out

14239 W Bell Rd Ste 108
Surprise, AZ 85374-2470
Phone: (623) 248-4283
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (8)

  • 3011 S Lindsay Rd Ste 101, Gilbert, AZ 85295-4333 — (480) 726-2500
  • 3130 E Baseline Rd Ste 107, Mesa, AZ 85204-7290 — (480) 345-1980
  • 2919 S Ellsworth Rd Ste 111, Mesa, AZ 85212-2165 — (480) 564-1185
  • 15256 N 75th Ave Ste 360, Peoria, AZ 85381-4761 — (623) 486-2424
  • 20860 N Tatum Blvd Ste 290, Phoenix, AZ 85050-4282 — (480) 563-1144
  • 1277 E Missouri Ave Ste 101, Phoenix, AZ 85014-2916 — (602) 296-4060
  • 270 E Hunt Hwy Ste A-2, San Tan Valley, AZ 85143-4962 — (480) 882-2222
  • 2145 E Warner Rd Ste 104, Tempe, AZ 85284-3549 — (480) 664-9443

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10227 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 70349500001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 7047150001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 7209350001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 7939960001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 704516001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 7046960001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 8220410001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 7629170001 (AZ)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 7057360001 (AZ)

Record details

NPI number1811770910
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 14, 2023
Last updated in NPPESMay 21, 2024
Certification dateMay 21, 2024
Mailing address1839 S Alma School Rd Ste 354, Mesa, AZ 85210-3028

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Afc Of Surprise, Pllc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Surprise