Individual provider Active NPI

Daryn Joseph Flentje, RN

  • Home Health Registered Nurse
  • Lodi, WI
National Provider Identifier
1467600635
Registry record updated Aug 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
126423030 Issued in WI
Practice address
129 Joyce Dr
Lodi, WI 53555-1366
Phone
(608) 592-1234
NPI assigned
Aug 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 126423030 WI Primary

Addresses

Primary practice location

129 Joyce Dr
Lodi, WI 53555-1366

Mailing address

129 Joyce Dr
Lodi, WI 53555-1366
Phone (608) 592-1234

Other identifiers 1

IdentifierTypeStateIssuer
39986200MedicaidWI

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
126423030WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1220054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220054400000",
    "number": "1467600635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 JOYCE DR",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551366",
            "telephone_number": "608-592-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 JOYCE DR",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551366",
            "telephone_number": "608-592-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLENTJE",
        "first_name": "DARYN",
        "middle_name": "JOSEPH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-30",
        "last_updated": "2008-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "126423030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39986200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2008; 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.