Individual provider Active NPI

Kristyn Jorgensen

  • Speech-Language Pathologist
  • Surprise, AZ
National Provider Identifier
1710499785
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP16414 Issued in AZ
Practice address
15116 N Cotton LN
Surprise, AZ 85388-9618
Phone
(623) 322-8250
NPI assigned
Oct 31, 2017
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TSLP16414 AZ Primary

Addresses

Primary practice location

15116 N Cotton LN
Surprise, AZ 85388-9618

Mailing address

24546 N 164TH Dr
Surprise, AZ 85387-2179
Phone (623) 628-5566

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

LicenseStateTypeSpecialty
TSLP16414AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
T.E.a.M. 4 Kids, LLC Speech-Language Pathologist CurrentSince Sep 21, 2025 Accepting new patients
Wee Care Corporation Speech-Language Pathologist Past Accepting new patients

Locations

15116 N Cotton Ln
Surprise, AZ 85388
Phone (623) 322-8250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1710499785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24546 N 164TH DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853872179",
            "telephone_number": "623-628-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15116 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889618",
            "telephone_number": "623-322-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "KRISTYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP16414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.