Active NPI
Jennifer Sorg, NP
- Psychiatric/Mental Health Nurse Practitioner
- Gilbert, AZ
National Provider Identifier
1326458381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 28193085A
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28193085A | Other | IN | LICENSE |
| 248632 | Other | AZ | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28193085A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Network, Inc | Current | Accepting new patients | |
| Community Health Network, Inc | Current | Accepting new patients | |
| Desert Shores Pediatrics | Current | 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
- https://fhir4.healow.com/fhir/r4/FDGBAA
- 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.
-
- Pediatrics Physician
- Gilbert, AZ
- NPI 1124386487
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Indianapolis, IN
- NPI 1265477632
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1336119478
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.