Rebecca A Jorgenson, DPT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

9073 Issued in MN

Practice address

11995 Singletree LN
Suite 120
Eden Prairie, MN 55344-5347

Phone

(952) 373-5720

NPI assigned

Feb 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca A Shane Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1912322835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "SUITE 120",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-373-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "SUITE 120",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-373-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-28",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MN",
            "license": "9073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "SHANE",
            "middle_name": "A",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kendall M Jones, MD
• Larry Keith Jordan, M.D.
• Roberta Marie Jordan, CNM, FNP
• Taylor R Jordan, M.D.
• Jason Macrae Jorgensen, DC
• Kristen Willis Joseph, NP-C
• Carli Jean Jost, PT, DPT
• Journey of the Heart, Inc.
• Mario James Juliano, MD
• Jenna Lynn Junot, PHARMD

• Sports Physical Therapist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Sports Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.