Individual provider Active NPI

Jennifer Marie Gonzalez, CNIM, R.EP.T

  • Electroneurodiagnostic Specialist/Technologist
  • Scottsdale, AZ
National Provider Identifier
1558080671
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
License
1703 Issued in AZ
Practice address
8655 E Via de Ventura Ste E160
Scottsdale, AZ 85258-3395
Phone
(480) 596-1686
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0600X 1703 AZ Primary

Addresses

Primary practice location

8655 E Via de Ventura Ste E160
Scottsdale, AZ 85258-3395

Mailing address

8655 E Via de Ventura Ste E160
Scottsdale, AZ 85258-3395

Other identifiers 1

IdentifierTypeStateIssuer
1703OtherAZABRET

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jisbell@stsiom.com Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1703AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sensory Testing Systems, LLC Single Specialty CurrentSince Aug 28, 2022 Accepting new patients

Locations

8655 E Via de Ventura
Ste E160
Scottsdale, AZ 85258
Phone (480) 247-3747

Organizations & group practices 1

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1558080671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8655 E VIA DE VENTURA STE E160",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 E VIA DE VENTURA STE E160",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583395",
            "telephone_number": "480-596-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "CNIM, R.EP.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "AZ",
            "license": "1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABRET",
            "identifier": "1703",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jisbell@stsiom.com",
            "affiliation": "N",
            "endpointDescription": "secure email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "8655 E Via De Ventura Ste E160",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852583395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.