Active NPI
Brina Rochelle Jergenson, R.D.
- Registered Dietitian
- Chandler, AZ
National Provider Identifier
1275753527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 844424
- Practice address
- 3200 N Dobson Rd
Building C; Suite 113
Chandler, AZ 85224-9601 - Phone
- (602) 538-6852
- Fax
- (480) 491-5719
- NPI assigned
- Apr 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 844424 | Primary |
Addresses
Primary practice location
3200 N Dobson Rd
Building C; Suite 113
Chandler, AZ 85224-9601
Mailing address
3200 N Dobson Rd
Building C; Suite 113
Chandler, AZ 85224-9601
Phone (602) 538-6852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A New Beginning Outpatient Treatment Center | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Scottsdale, AZ
- NPI 1124225669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1275753527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 N DOBSON RD",
"address_2": "BUILDING C; SUITE 113",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852249601",
"telephone_number": "602-538-6852",
"fax_number": "480-491-5719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 N DOBSON RD",
"address_2": "BUILDING C; SUITE 113",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852249601",
"telephone_number": "602-538-6852",
"fax_number": "480-491-5719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JERGENSON",
"first_name": "BRINA",
"middle_name": "ROCHELLE",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-27",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "844424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.