Dwan Renee Kendrick, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R035704 Issued in SD

Practice address

210 First Street
Wanblee, SD 57577

Phone

(605) 462-6155

NPI assigned

Dec 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Pine Ridge Indian Health Service Hospital

  dba Wanblee Health Center

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD (past)

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1003184607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290",
            "city": "WANBLEE",
            "state": "SD",
            "postal_code": "575770290",
            "telephone_number": "605-462-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FIRST STREET",
            "city": "WANBLEE",
            "state": "SD",
            "postal_code": "57577",
            "telephone_number": "605-462-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "DWAN",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R035704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arelis Benitez-Quinones, MD
• Robyn L Black Feather, CSW-PIP
• Suzanne Marie England, APRN, CNP
• Heather Jo Hutchinson, PHARMD
• Alexandria M Jones, MA, NCC, LPC
• Denise Kovach
• Anita Marie Masaitis, DMD
• Jaimee Allisen McGuire, DNP, RN, NP-C
• Pine Ridge Indian Health Service (Wanblee Health Center)
• Pine Ridge Indian Health Service Hospital (Wanblee Health Center)

• Registered Nurse in Wanblee, SD
• Providers in Wanblee, SD by specialty
• Registered Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.