Active NPI
Kaylee Jorgensen, OTD-OTR/L
- Pediatric Occupational Therapist
- Springfield, TN
National Provider Identifier
1588439913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 7764
- Practice address
- 3933 Memorial Blvd
Springfield, TN 37172-4200 - Phone
- (615) 382-0500
- Fax
- (615) 382-0501
- NPI assigned
- Nov 15, 2023
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 7764 | TN | Primary |
Addresses
Primary practice location
3933 Memorial Blvd
Springfield, TN 37172-4200
Mailing address
PO Box 1637
Springfield, TN 37172-1637
Phone (615) 988-4552
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Springfield | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7764 | TN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Pediatric Therapy Center PLLC | Past | Accepting new patients | |
| Shine Pediatric Therapy | 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.
-
- Occupational Therapist
- Springfield, TN
- NPI 1891041133
-
- Specialist
- Springfield, TN
- NPI 1639303142
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1588439913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1637",
"city": "SPRINGFIELD",
"state": "TN",
"postal_code": "371721637",
"telephone_number": "615-988-4552",
"fax_number": "615-382-0501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3933 MEMORIAL BLVD",
"city": "SPRINGFIELD",
"state": "TN",
"postal_code": "371724200",
"telephone_number": "615-382-0500",
"fax_number": "615-382-0501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "KAYLEE",
"credential": "OTD-OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-15",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TN",
"license": "7764",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Springfield",
"affiliation": "N",
"endpointDescription": "Office",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3933 Memorial Blvd",
"city": "Springfield",
"state": "TN",
"country_code": "US",
"postal_code": "371724200",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Springfield, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.