Active NPI
Deirdre Dantzler, R.N.
- Registered Nurse
- Jamaica, NY
National Provider Identifier
1659771004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 690352
- Practice address
- 172 30 133Rd Ave
Apt 11B
Jamaica, NY 11434 - Phone
- (718) 527-3710
- NPI assigned
- Sep 3, 2014
- Last updated
- Sep 3, 2014
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 690352 | NY | Primary |
Addresses
Primary practice location
172 30 133Rd Ave
Apt 11B
Jamaica, NY 11434
Mailing address
172 30 133Rd Ave
Apt 11B
Jamaica, NY 11434
Phone (718) 527-3710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 690352 | Other | NY | NYS RN LICENCE |
Other names 1
- Mrs. Deirdre Dantzler-Pearson
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
| License | State | Type | Specialty |
|---|---|---|---|
| 690352 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1659771004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 30 133RD AVE",
"address_2": "APT 11B",
"city": "JAMAICA",
"state": "NY",
"postal_code": "11434",
"telephone_number": "718-527-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 30 133RD AVE",
"address_2": "APT 11B",
"city": "JAMAICA",
"state": "NY",
"postal_code": "11434",
"telephone_number": "718-527-3710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANTZLER",
"first_name": "DEIRDRE",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-03",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "690352",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS RN LICENCE",
"identifier": "690352",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEIRDRE",
"last_name": "DANTZLER-PEARSON",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.