Individual provider Active NPI

Mark Balandra Zerrudo, RN

  • Registered Nurse
  • McKinney, TX
National Provider Identifier
1497455935
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
786267 Issued in TX
Practice address
230 E Hunt St Ste 201-202
McKinney, TX 75069-3820
Phone
(972) 632-8363
NPI assigned
Mar 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 786267 TX Primary

Addresses

Primary practice location

230 E Hunt St Ste 201-202
McKinney, TX 75069-3820

Mailing address

212 Los Rios Dr
McKinney, TX 75072-8928
Phone (972) 632-8363

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
786267TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1497455935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 LOS RIOS DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750728928",
            "telephone_number": "972-632-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E HUNT ST STE 201-202",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693820",
            "telephone_number": "972-632-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZERRUDO",
        "first_name": "MARK",
        "middle_name": "BALANDRA",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "786267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.