Individual provider Active NPI

Rita K Adeniran

  • Administrator Registered Nurse
  • Drexel Hill, PA
National Provider Identifier
1386227155
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
RN312491L Issued in PA
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
101540673MedicaidPA

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
RN312491LPAMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.