Individual provider Active NPI

Jennifer Sorg, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1326458381
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
28193085A Issued in IN
Practice address
6285 S Higley Rd
Gilbert, AZ 85298-4262
Phone
(480) 460-4949
Fax
(480) 460-5858
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 28193085A IN Primary

Addresses

Primary practice location

6285 S Higley Rd
Gilbert, AZ 85298-4262

Mailing address

6285 S Higley Rd
Gilbert, AZ 85298-4262
Phone (480) 460-4949

Other identifiers 2

IdentifierTypeStateIssuer
28193085AOtherINLICENSE
248632OtherAZSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsorg327918@eCommunityDirect.com Community Health Network, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28193085AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc Current Accepting new patients
Community Health Network, Inc CurrentSince Oct 22, 2018 Accepting new patients
Desert Shores Pediatrics CurrentSince Dec 6, 2020 Accepting new patients

Locations

6285 S Higley Rd
Gilbert, AZ 85298
Phone (480) 227-0804

7165 Clearvista Way
Indianapolis, IN 46256
Phone (317) 621-5100

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDGBAA
  • Direct secure messaging: jsorg327918@ecommunitydirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1326458381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6285 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984262",
            "telephone_number": "480-460-4949",
            "fax_number": "480-460-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6285 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984262",
            "telephone_number": "480-460-4949",
            "fax_number": "480-460-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORG",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28193085A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "28193085A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "248632",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsorg327918@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Network, Inc",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.