Christine Jorgensen, MAT, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT#4479 Issued in TX

Practice address

3604 Poteet Dr Apt 217
Mesquite, TX 75150-7650

Phone

(469) 585-6441

NPI assigned

Jul 27, 2015

Last updated

Jul 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1659756039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 POTEET DR APT 217",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751507650",
            "telephone_number": "469-585-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 POTEET DR APT 217",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751507650",
            "telephone_number": "469-585-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "CHRISTINE",
        "credential": "MAT, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT#4479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "AT#4479",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cylinda Jordan
• Labretha Jordan
• Julia Jose, OD
• Abu Abraham Joseph, DO
• Carmel Maria Joseph, DO
• Danisha Joseph, LCSW
• Mary Joseph, MSN, APRN, FNP-C

• Athletic Trainer in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.