Active NPI
Ruth Renteria
- Nurse Practitioner
- Dallas, TX
National Provider Identifier
1619784048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1181515
- Practice address
- 4104 Junius St
Dallas, TX 75246-1427 - Phone
- (972) 707-7782
- Fax
- (800) 834-0522
- NPI assigned
- Dec 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1181515 | TX | Primary |
Addresses
Primary practice location
4104 Junius St
Dallas, TX 75246-1427
Mailing address
1104 E Hidden Lakes Dr
Desoto, TX 75115-5876
Other practice location 1
4414 Lovers Ln
Dallas, TX 75225-6923
Phone (469) 809-6858
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1181515 | TX | MD | Nurse Practitioner |
Interoperability endpoints
- ruth.renteria.1@17617.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1619784048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 E HIDDEN LAKES DR",
"city": "DESOTO",
"state": "TX",
"postal_code": "751155876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4104 JUNIUS ST",
"city": "DALLAS",
"state": "TX",
"postal_code": "752461427",
"telephone_number": "972-707-7782",
"fax_number": "800-834-0522"
}
],
"practiceLocations": [
{
"address_1": "4414 Lovers Ln",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752256923",
"country_code": "US",
"telephone_number": "469-809-6858",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RENTERIA",
"first_name": "RUTH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-18",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1181515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.