Individual provider Active NPI

Jose Joaquin Grajales Sr., RN BSN COHN

  • General Practice Registered Nurse
  • Moca, PR
National Provider Identifier
1144606708
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
22706 Issued in PR
Practice address
241 Calle Barbosa
Moca, PR 00676
Phone
(787) 641-0773
NPI assigned
Aug 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 22706 PR Primary

Addresses

Primary practice location

241 Calle Barbosa
Moca, PR 00676

Mailing address

PO Box 250106
Aguadilla, PR 00604-0106
Phone (787) 510-9165

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
22706PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1144606708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250106",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006040106",
            "telephone_number": "787-510-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 CALLE BARBOSA",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "787-641-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJALES",
        "first_name": "JOSE",
        "middle_name": "JOAQUIN",
        "name_suffix": "Sr.",
        "credential": "RN BSN COHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "PR",
            "license": "22706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.