Jerrie Denise San Luis, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

652119 Issued in TX

Practice address

1110 W William Cannon Dr Ste 303
Austin, TX 78745-3188

Phone

(512) 899-2100

Fax

(512) 899-2205

NPI assigned

Mar 25, 2022

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 identifiers 1

Electronic endpoints 2

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 and National Provider Directory roles.

• Maintenance and Recovery Services, Inc.

  • Methadone Clinic
  • San Antonio, TX
  • NPI 1477264307
  NPD (past)
• Mars S a LLC

  • Methadone Clinic
  • San Antonio, TX
  • NPI 1811417397
  NPD (past)
• Medication Assisted Recovery Services Mars, LLC

  • Methadone Clinic
  • Cedar Park, TX
  • NPI 1285346718
  NPD (past)
• Medication Assisted Recovery Services Mars, LLC

  • Methadone Clinic
  • Cedar Park, TX
  • NPI 1689194151
  NPD (past)

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1013667708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W WILLIAM CANNON DR STE 303",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453188",
            "telephone_number": "512-899-2100",
            "fax_number": "512-899-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W WILLIAM CANNON DR STE 303",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453188",
            "telephone_number": "512-899-2100",
            "fax_number": "512-899-2205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Ferguson Dr",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787533006",
            "country_code": "US",
            "telephone_number": "512-339-9757 x582",
            "fax_number": "512-339-9747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "437 McCarty Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782164445",
            "country_code": "US",
            "telephone_number": "210-314-1934 x579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Arrow Point Dr Ste 214",
            "address_purpose": "LOCATION",
            "city": "Cedar Park",
            "state": "TX",
            "postal_code": "786137739",
            "country_code": "US",
            "telephone_number": "512-986-7743 x563",
            "fax_number": "512-986-7759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAN LUIS",
        "first_name": "JERRIE",
        "middle_name": "DENISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "652119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE LICENSE-REGISTERED NURSE",
            "identifier": "652119",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1110 W William Cannon Dr Ste 303",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787453188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "denise.sanluis@cmsgiveshope.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1101 Arrow Point Dr Ste 214",
            "city": "Cedar Park",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786137739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samz Mental Health LLC
• San Antonio Osteo Relief Center PA
• San Diego Lithotripters LP I
• San Diego Urology Services LLC
• San Jacinto Chiropractic Inc.
• Nicholas Andre San Roman, MD
• Sana Nutrition and Wellness LLC
• Sana Psychiatry, PLLC
• Sana Sana Counseling, PLLC
• Sophie Sanati, LMSW

• Addiction (Substance Use Disorder) Registered Nurse in Austin, TX
• Providers in Austin, TX by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.