Individual provider Active NPI

Pete Michael Zentkovich, RN

  • Registered Nurse
  • Fairchance, PA
National Provider Identifier
1164933891
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN583935 Issued in PA
Practice address
5 Sheldon Ave
Fairchance, PA 15436-1022
Phone
(724) 322-4401
NPI assigned
Oct 20, 2017
Last updated
Oct 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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 RN583935 PA Primary

Addresses

Primary practice location

5 Sheldon Ave
Fairchance, PA 15436-1022

Mailing address

5 Sheldon Ave
Fairchance, PA 15436-1022
Phone (724) 322-4401

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
RN583935PAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1164933891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SHELDON AVE",
            "city": "FAIRCHANCE",
            "state": "PA",
            "postal_code": "154361022",
            "telephone_number": "724-322-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SHELDON AVE",
            "city": "FAIRCHANCE",
            "state": "PA",
            "postal_code": "154361022",
            "telephone_number": "724-322-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENTKOVICH",
        "first_name": "PETE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN583935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairchance, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.