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JACKSON TARAVINE SR
NPI 1467316042
Physician Assistant - Medical in Chandler, AZ

Active since December 09, 2025
1256 W CHANDLER BLVD STE G, CHANDLER, AZ 85224(480) 712-7108(480) 300-5840 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 3, 2026, Dec 9, 2025 (2 updates tracked since 2025).

About Jackson Taravine Sr NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON TARAVINE SR (NPI 1467316042) is a healthcare organization registered as a medical in Chandler, Arizona and active in the NPI registry since December 2025. The organization lists Jackson Taravine, Owner, as its authorized official.

NPPES Registry Identity

NPI1467316042
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameJACKSON TARAVINE SR
Location Address1256 W CHANDLER BLVD STE GChandler, AZ 85224-5208
Mailing Address15182 N 75th Ave Ste 180Peoria, AZ 85381-4722 · (480) 300-5798 · Fax (480) 300-5840
Phone(480) 712-7108
Fax(480) 300-5840
Organization SubpartNo
Authorized OfficialJackson TaravineOwner · (786) 865-3586
Enumeration DateDecember 9, 2025
Last NPPES UpdateMarch 3, 20262 updates tracked since enumeration
NPPES CertifiedMarch 3, 2026
✔ NPI 1467316042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
1256 W CHANDLER BLVD STE G, Chandler, AZ 85224
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Taravine Sr's NPI number?

The NPI number for Jackson Taravine Sr is 1467316042. It was assigned to this organization in the NPPES registry on December 9, 2025.

Where is Jackson Taravine Sr located?

Jackson Taravine Sr is located at 1256 W Chandler Blvd Ste G, Chandler, AZ 85224. The listed phone number is (480) 712-7108.

What is Jackson Taravine Sr's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Jackson Taravine Sr was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.