Individual provider Active NPI

Janet Marie Knesek, REGISTERED NURSE

  • Registered Nurse
  • Rancho Cordova, CA
National Provider Identifier
1104414291
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
622725 Issued in CA
Practice address
3301 Zinfandel Dr
Rancho Cordova, CA 95670-6385
Phone
(916) 852-8332
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 622725 CA Primary

Addresses

Primary practice location

3301 Zinfandel Dr
Rancho Cordova, CA 95670-6385

Mailing address

11130 Jordan River CT
Rancho Cordova, CA 95670-2945
Phone (916) 622-2830

Other names 1

  • Miss Janet M Knesek Former name

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

State licenses

LicenseStateTypeSpecialty
622725CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. PastSince Jan 10, 2021 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Jan 10, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1104414291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 JORDAN RIVER CT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702945",
            "telephone_number": "916-622-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 ZINFANDEL DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706385",
            "telephone_number": "916-852-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNESEK",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "622725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "KNESEK",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.