Individual provider Active NPI

Joaquin Damon Kline, RN

  • Registered Nurse
  • Rio Rancho, NM
National Provider Identifier
1649547613
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN-73567 Issued in NM
Practice address
3752 Clear Creek Rd NE
Rio Rancho, NM 87144-3704
Phone
(954) 740-1404
NPI assigned
Nov 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-73567 NM Primary
Registered Nurse 163W00000X RN-9307653 FL

Addresses

Primary practice location

3752 Clear Creek Rd NE
Rio Rancho, NM 87144-3704

Mailing address

3752 Clear Creek Rd NE
Rio Rancho, NM 87144-3704
Phone (954) 740-1404

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
RN-9307653FLMDRegistered Nurse
RN-73567NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1649547613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3752 CLEAR CREEK RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871443704",
            "telephone_number": "954-740-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3752 CLEAR CREEK RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871443704",
            "telephone_number": "954-740-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "JOAQUIN",
        "middle_name": "DAMON",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-19",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-73567",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN-9307653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.