Individual provider Active NPI

Diane Patricia Jenkins-King, RN CRRN

  • Rehabilitation Registered Nurse
  • Gainesville, FL
National Provider Identifier
1255923645
Registry record updated Feb 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Registered NurseTaxonomy code 163WR0400X
License
RN2802612 Issued in FL
Practice address
2708 SW Archer Rd
Gainesville, FL 32608-1316
Phone
(352) 554-2170
NPI assigned
Feb 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Registered Nurse 163WR0400X RN2802612 FL Primary

Addresses

Primary practice location

2708 SW Archer Rd
Gainesville, FL 32608-1316

Mailing address

912 NW 101St Dr
Gainesville, FL 32606-8030
Phone (352) 682-1577

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
RN2802612FLMDRehabilitation Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612656000000",
    "number": "1255923645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 NW 101ST DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326068030",
            "telephone_number": "352-682-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081316",
            "telephone_number": "352-554-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS-KING",
        "first_name": "DIANE",
        "middle_name": "PATRICIA",
        "credential": "RN CRRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-07",
        "last_updated": "2021-02-07",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "FL",
            "license": "RN2802612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2021; 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.