Individual provider Active NPI

Renee A Jelinek, M.D.

  • Internal Medicine Physician
  • Prescott, AZ
National Provider Identifier
1134211527
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25634 Issued in AZ
Practice address
500 N Hwy 89
Northern Arizona VA HCS
Prescott, AZ 86313
Phone
(928) 445-4860
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25634 AZ Primary
Internal Medicine Physician 207R00000X ME78147 FL

Addresses

Primary practice location

500 N Hwy 89
Northern Arizona VA HCS
Prescott, AZ 86313

Mailing address

1345 Coyote Rd
Prescott, AZ 86313
Phone (928) 445-4860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25634AZMDInternal Medicine Physician
ME78147FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134211527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 COYOTE RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HWY 89",
            "address_2": "NORTHERN ARIZONA VA HCS",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELINEK",
        "first_name": "RENEE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "25634",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78147",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.