Individual provider Active NPI

Kai Harper

  • Licensed Vocational Nurse
  • San Bernardino, CA
National Provider Identifier
1568066785
Registry record updated Nov 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
254252 Issued in CA
Practice address
967 Kendall Dr # A329
San Bernardino, CA 92407-4306
Phone
(909) 689-6095
NPI assigned
Nov 29, 2020
Last updated
Nov 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 254252 CA Primary

Addresses

Primary practice location

967 Kendall Dr # A329
San Bernardino, CA 92407-4306

Mailing address

967 Kendall Dr # A329
San Bernardino, CA 92407-4306
Phone (909) 689-6095

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Peacockdesertrose@yahoo.com Peacock Desert Rose Services Limited

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
254252CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peacock Desert Rose Services Limited Licensed Vocational Nurse CurrentSince Dec 6, 2020 Accepting new patients

Locations

967 Kendall Dr
#A329
San Bernardino, CA 92407
Phone (909) 689-6095

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": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1568066785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 KENDALL DR # A329",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924074306",
            "telephone_number": "909-689-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 KENDALL DR # A329",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924074306",
            "telephone_number": "909-689-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "KAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-29",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "254252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Peacockdesertrose@yahoo.com",
            "affiliation": "Y",
            "affiliationName": "Peacock Desert Rose Services Limited",
            "address_1": "967 Kendall Dr # A329",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924074306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; 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.