Jasen A McKenrick

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HA4122 Issued in CA

Practice address

80150 US Highway 111
Suite C2
Indio, CA 92201-8359

Phone

(760) 863-5900

Fax

(760) 863-5912

NPI assigned

Feb 17, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1245503457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44630 MONTEREY AVE",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603326",
            "telephone_number": "760-863-5900",
            "fax_number": "760-863-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80150 US HIGHWAY 111",
            "address_2": "SUITE C2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922018359",
            "telephone_number": "760-863-5900",
            "fax_number": "760-863-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENRICK",
        "first_name": "JASEN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA4122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Jon McDonald, CADC I
• Jade Elizabeth McGarry
• Mark Joseph McGowan Sr.
• Kathleen Marie McIntosh
• Aisha Liana McKee
• Leanna McKeough, LVN
• Chyanne Elena McKinley
• Beth McLaughlin
• Michaela Lea McLean, PT, DPT
• Tahlib James McMicheaux I

• Hearing Instrument Specialist in Indio, CA
• Providers in Indio, CA by specialty
• Hearing Instrument Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.