Gary Q Jorgensen, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

103687-2501 Issued in UT

Practice address

501 Chipeta Way
Salt Lake City, UT 84108-1222

Phone

(801) 598-4187

Fax

(801) 523-0263

NPI assigned

Mar 2, 2007

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679601264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 901535",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840901535",
            "telephone_number": "801-598-4187",
            "fax_number": "801-523-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081222",
            "telephone_number": "801-598-4187",
            "fax_number": "801-523-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "GARY",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "103687-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C0144",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zane S. Jordan, MD
• Kayla E. Jordanova, MD
• Alycia N Jordison
• Mary Jorgensen Evans
• Alanna Brooke Jorgensen, PA
• Heidie Jane Jorgensen
• Jercie Jorgensen
• Jon Jorgensen
• Jonathan Arthur Jorgensen
• Joshua Jorgensen, MSN, FNP-C

• Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.