Active NPI
Kimijuan Anderson
- Durable Medical Equipment & Medical Supplies
- Houston, TX
National Provider Identifier
1649904145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- Serenitydiabeticmedical@Gmail.Com
14230 Wunderlich Drive Apt 264
Houston, TX 77069 - Phone
- (504) 952-0797
- NPI assigned
- Jul 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
Serenitydiabeticmedical@Gmail.Com
14230 Wunderlich Drive Apt 264
Houston, TX 77069
Mailing address
Serenitydiabeticmedical@Gmail.Com
14230 Wunderlich Drive Apt 264
Houston, TX 77069
Phone (504) 952-0797
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86-3861086 | Other | TX | MEDICAL SUPPLIES |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1649904145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SERENITYDIABETICMEDICAL@GMAIL.COM",
"address_2": "14230 WUNDERLICH DRIVE APT 264",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77069",
"telephone_number": "504-952-0797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SERENITYDIABETICMEDICAL@GMAIL.COM",
"address_2": "14230 WUNDERLICH DRIVE APT 264",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77069",
"telephone_number": "504-952-0797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KIMIJUAN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2022-07-12",
"certification_date": "2022-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL SUPPLIES",
"identifier": "86-3861086",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.