Active NPI
Sarah Jorgenson, RPH
- Pharmacist
- Eau Claire, WI
National Provider Identifier
1619556396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11695-040
- Practice address
- 3915 Gateway Dr
Eau Claire, WI 54701-8166 - Phone
- (715) 834-5966
- NPI assigned
- Apr 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11695-040 | WI | Primary |
Addresses
Primary practice location
3915 Gateway Dr
Eau Claire, WI 54701-8166
Mailing address
S4410 Rygg Rd
Eau Claire, WI 54701-9757
Phone (715) 590-4203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11695-040 | Other | WI | WISCONSIN PHARMACIST LICENSE |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11695-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1619556396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "S4410 RYGG RD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547019757",
"telephone_number": "715-590-4203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GATEWAY DR",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547018166",
"telephone_number": "715-834-5966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSON",
"first_name": "SARAH",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-07",
"last_updated": "2021-04-07",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "WI",
"license": "11695-040",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN PHARMACIST LICENSE",
"identifier": "11695-040",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.