Individual provider Active NPI

Rene De Jesus, RN

  • Hemodialysis Registered Nurse
  • Pembroke Pines, FL
National Provider Identifier
1063921039
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hemodialysis Registered NurseTaxonomy code 163WH0500X
License
9305290 Issued in FL
Practice address
8370 NW 39TH CT
Pembroke Pines, FL 33024-5053
Phone
(305) 505-0534
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hemodialysis Registered Nurse 163WH0500X 9305290 FL Primary

Addresses

Primary practice location

8370 NW 39TH CT
Pembroke Pines, FL 33024-5053

Mailing address

8370 NW 39TH Court
Pembroke Pines, FL 33024
Phone (754) 229-8515

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
9305290FLMDHemodialysis Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1063921039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8370 NW 39TH COURT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "754-229-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8370 NW 39TH CT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330245053",
            "telephone_number": "305-505-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "RENE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hemodialysis",
            "state": "FL",
            "license": "9305290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; 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.