Individual provider Active NPI

Rhonda S Fender, NNP

  • Neonatal Nurse Practitioner
  • Maplewood, MN
National Provider Identifier
1306805312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
R166507-5 Issued in MN
Practice address
1655 Beam Ave
Suite 302
Maplewood, MN 55109-1163
Phone
(651) 232-7031
Fax
(651) 232-7826
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X R166507-5 MN Primary

Addresses

Primary practice location

1655 Beam Ave
Suite 302
Maplewood, MN 55109-1163

Mailing address

7811 Ivystone Ave S
Cottage Grove, MN 55016-2140
Phone (651) 458-0567

Other names 1

  • Rhonda S Keast Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260514000514 TX Practitioner - Nurse Practitioner 4587566856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1102 Bates Ave
Houston, TX 77030-2698

PO Box
Dallas, TX 75284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R166507-5MNMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group Past Accepting new patients
Unm Medical Group Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306805312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7811 IVYSTONE AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550162140",
            "telephone_number": "651-458-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BEAM AVE",
            "address_2": "SUITE 302",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091163",
            "telephone_number": "651-232-7031",
            "fax_number": "651-232-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDER",
        "first_name": "RHONDA",
        "middle_name": "S",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "R166507-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHONDA",
            "last_name": "KEAST",
            "middle_name": "S",
            "credential": "NNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.