Active NPI
Rita K Adeniran
- Administrator Registered Nurse
- Drexel Hill, PA
National Provider Identifier
1386227155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- RN312491L
- Practice address
- 1230 Burmont Rd
Drexel Hill, PA 19026-4504 - Phone
- (610) 513-7587
- Fax
- (610) 449-1175
- NPI assigned
- Apr 29, 2021
- Last updated
- May 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | RN312491L | PA | |
| Continuing Education/Staff Development Registered Nurse | 163WC1600X | RN312491L | PA | |
| Home Health Registered Nurse | 163WH0200X | RN312491L | PA | |
| Registered Nurse | 163W00000X | RN312491L | PA | |
| Administrator Registered Nurse | 163WA2000X | RN312491L | PA | Primary |
Addresses
Primary practice location
1230 Burmont Rd
Drexel Hill, PA 19026-4504
Mailing address
1230 Agnew Dr
Drexel Hill, PA 19026-1810
Phone (215) 573-6036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101540673 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN312491L | PA | MD | Administrator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health1St LLC | Current | Accepting new patients |
Locations
1230 Burmont Rd
Drexel Hill, PA 19026
Phone (610) 449-1175
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1386227155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 AGNEW DR",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190261810",
"telephone_number": "215-573-6036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 BURMONT RD",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190264504",
"telephone_number": "610-513-7587",
"fax_number": "610-449-1175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADENIRAN",
"first_name": "RITA",
"middle_name": "K",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-29",
"last_updated": "2021-05-21",
"certification_date": "2021-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "PA",
"license": "RN312491L",
"primary": false
},
{
"code": "163WC1600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Continuing Education/Staff Development",
"state": "PA",
"license": "RN312491L",
"primary": false
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "PA",
"license": "RN312491L",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN312491L",
"primary": false
},
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "PA",
"license": "RN312491L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101540673",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Drexel Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.