Organization Active NPI

CJT Enterprises, Inc.

  • Customized Equipment (DME)
  • Fountain Valley, CA
National Provider Identifier
1508052192
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
CJT ENTERPRISES, INC.
Practice address
11661 Martens River Cir Ste C
Fountain Valley, CA 92708-4212
Phone
(714) 751-6295
Fax
(714) 751-5775
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Carrie Sohrt McCormick
Title
Ceo
Phone
(714) 751-6295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

11661 Martens River Cir Ste C
Fountain Valley, CA 92708-4212

Mailing address

17870 Newhope St Unit 104-457
Fountain Valley, CA 92708-5439
Phone (714) 751-6295

Other practice location 1

2732 W Juniper St
Unit 1
Santa Ana, CA 92704-0910
Phone (714) 751-6295

Other identifiers 1

IdentifierTypeStateIssuer
368177MedicaidAZ

National Provider Directory

National Provider Directory

Locations

11661 Martens River Cir
Ste C
Fountain Valley, CA 92708
Phone (714) 751-6295

17870 Newhope St
Unit 104457
Fountain Valley, CA 92708

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508052192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17870 NEWHOPE ST UNIT 104-457",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085439",
            "telephone_number": "714-751-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 MARTENS RIVER CIR STE C",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084212",
            "telephone_number": "714-751-6295",
            "fax_number": "714-751-5775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2732 W Juniper St",
            "address_2": "Unit 1",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927040910",
            "country_code": "US",
            "telephone_number": "714-751-6295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CJT ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "SOHRT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-751-6295",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368177",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.