Active NPI
Kelly Michelle Jorgensen, PHARMD
- Pharmacist
- Sauk City, WI
National Provider Identifier
1700138948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14432
- Practice address
- 245 Sycamore St
Sauk City, WI 53583-1013 - Phone
- (608) 644-9265
- Fax
- (608) 643-2629
- NPI assigned
- Oct 11, 2012
- Last updated
- Jun 21, 2019
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14432 | WI | Primary |
Addresses
Primary practice location
245 Sycamore St
Sauk City, WI 53583-1013
Mailing address
1306 Gile Dr
Waunakee, WI 53597-2660
Phone (763) 355-4949
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14432 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1700138948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1306 GILE DR",
"city": "WAUNAKEE",
"state": "WI",
"postal_code": "535972660",
"telephone_number": "763-355-4949",
"fax_number": "608-850-4992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 SYCAMORE ST",
"city": "SAUK CITY",
"state": "WI",
"postal_code": "535831013",
"telephone_number": "608-644-9265",
"fax_number": "608-643-2629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "KELLY",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-11",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "14432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sauk City, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.