Individual provider Active NPI

Omar Reveron Feliciano

  • Basic Emergency Medical Technician
  • Isabela, PR
National Provider Identifier
1215234125
Registry record updated Jun 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
1887-B Issued in PR
Practice address
2525 Calle Francia
Isabela, PR 00662-4829
Phone
(787) 514-5381
NPI assigned
Feb 13, 2011
Last updated
Jun 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 1887-B PR Primary

Addresses

Primary practice location

2525 Calle Francia
Isabela, PR 00662-4829

Mailing address

PO Box 498
San Antonio, PR 00690-0498
Phone (787) 514-5381

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
1887-BPRMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1297555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372464000000",
    "number": "1215234125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "city": "SAN ANTONIO",
            "state": "PR",
            "postal_code": "006900498",
            "telephone_number": "787-514-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CALLE FRANCIA",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006624829",
            "telephone_number": "787-514-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVERON FELICIANO",
        "first_name": "OMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-13",
        "last_updated": "2013-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "PR",
            "license": "1887-B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isabela, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2013; 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.