Individual provider Active NPI

Marc Anthony Arredondo

  • Home Health Registered Nurse
  • San Antonio, TX
National Provider Identifier
1164901674
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
836411 Issued in TX
Practice address
5726 W Hausman Rd
San Antonio, TX 78249-1650
Phone
(210) 349-7030
NPI assigned
Aug 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 836411 TX Primary

Addresses

Primary practice location

5726 W Hausman Rd
San Antonio, TX 78249-1650

Mailing address

4639 French Meadow St
San Antonio, TX 78250-4515
Phone (210) 287-2099

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
836411TXMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1164901674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4639 FRENCH MEADOW ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782504515",
            "telephone_number": "210-287-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 W HAUSMAN RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782491650",
            "telephone_number": "210-349-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "MARC",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "836411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.