Individual provider Active NPI

Katrina Chavez-Jorgensen, M.D.

  • Internal Medicine Physician
  • Hastings, NE
National Provider Identifier
1811309883
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30287 Issued in NE
Practice address
715 N Saint Joseph Ave
Hastings, NE 68901-4451
Phone
(402) 463-4521
NPI assigned
May 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7153 NE
Internal Medicine Physician 207R00000X 30287 NE Primary

Addresses

Primary practice location

715 N Saint Joseph Ave
Hastings, NE 68901-4451

Mailing address

3813 W 38TH St
Hastings, NE 68901-7393
Phone (308) 830-1888

Other identifiers 2

IdentifierTypeStateIssuer
7153OtherNETEP
30287OtherNEPERMANENT PHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004002178 NE Practitioner - HospitalistPractitioner - Internal Medicine 4981825288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Nebraska College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

715 N Saint Joseph Ave
Mary Lanning Healthcare
Hastings, NE 68901-4451
Phone (402) 463-4521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Mary Lanning Memorial Hospital Association CurrentSince Oct 1, 2017 Accepting new patients
The Mary Lanning Memorial Hospital Association CurrentSince Oct 1, 2017 Accepting new patients

Locations

715 N Saint Joseph Ave
Hastings, NE 68901
Phone (402) 461-5036

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811309883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 W 38TH ST",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689017393",
            "telephone_number": "308-830-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N SAINT JOSEPH AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014451",
            "telephone_number": "402-463-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ-JORGENSEN",
        "first_name": "KATRINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "7153",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "30287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEP",
            "identifier": "7153",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERMANENT PHYSICIAN LICENSE",
            "identifier": "30287",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

Sources for this page

Verify at the official NPI Registry.