Individual provider Active NPI

Jacqueline Marie Noble-Deschenes, NP

  • Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1497868087
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2922432 Issued in FL
Practice address
4033 Beaver LN
Port Charlotte, FL 33952-9206
Phone
(941) 625-3200
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2922432 FL Primary

Addresses

Primary practice location

4033 Beaver LN
Port Charlotte, FL 33952-9206

Mailing address

10303 Burnt Store Rd Unit 111
Punta Gorda, FL 33950-7979
Phone (941) 916-0662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041118000267 FL Practitioner - Nurse Practitioner 5799749800 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2922432FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arturo Rodriguez-Martin MD PL CurrentSince Jul 1, 2014 Accepting new patients

Locations

22099 Elmira Blvd
Pt Charlotte, FL 33952
Phone (941) 613-1356

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497868087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10303 BURNT STORE RD UNIT 111",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339507979",
            "telephone_number": "941-916-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 BEAVER LN",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529206",
            "telephone_number": "941-625-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE-DESCHENES",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2922432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.