Samuel Remus Cerezo, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

R179724 Issued in MD

Practice address

401 Buster Rd
Toppenish, WA 98948-9792

Phone

(509) 865-1710

NPI assigned

Dec 12, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1548077613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BUSTER RD",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989489792",
            "telephone_number": "509-865-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BUSTER RD",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989489792",
            "telephone_number": "509-865-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEREZO",
        "first_name": "SAMUEL",
        "middle_name": "REMUS",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MD",
            "license": "R179724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Care Registered Nurse in Toppenish, WA
• Providers in Toppenish, WA by specialty
• Ambulatory Care Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.