Jeanne Marie McEntire, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

12035 Issued in CA

Practice address

30210 Rancho Viejo Rd
San Juan Capistrano, CA 92675-1574

Phone

(949) 493-7337

NPI assigned

Aug 3, 2022

Last updated

Aug 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeanne Marie Kang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Coastal Kids, a Professional Medical Corporation

  dba Coastal Kids

  • Pediatrics Physician
  • Newport Beach, CA
  • NPI 1740311737
  NPD (past)

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1376270991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33071 SANTIAGO DR",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926291326",
            "telephone_number": "949-291-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30210 RANCHO VIEJO RD",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751574",
            "telephone_number": "949-493-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTIRE",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "12035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "KANG",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Mauer, PHARM.D.
• D Dawn Maxwell, M.A. CATC IV
• Mazolewski Oc Medical PC
• Don Ray McCanne, M.D.
• Breanna Nicole McDavid, DPT
• John Strother McGlinn IV
• Jill Marie McGovern, M.A.
• Alyssa McIntyre, SLP
• Pretty McLendon, NP
• Dalimari Yanin McMartin

• Pediatric Nurse Practitioner in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.