Active NPI
Jacqueline Lee Enterkin, RN
- Pediatric Skilled Nursing Facility
- Orlando, FL
National Provider Identifier
1689807703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Skilled Nursing Facility
- License
- RN 9286049
- Practice address
- 7040 Lake Ellenor Dr
Orlando, FL 32809-5750 - Phone
- (407) 858-6143
- Fax
- (407) 856-6594
- NPI assigned
- Aug 25, 2009
- 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 |
|---|---|---|---|---|
| Pediatric Skilled Nursing Facility | 3140N1450X | RN 9286049 | FL | Primary |
Addresses
Primary practice location
7040 Lake Ellenor Dr
Orlando, FL 32809-5750
Mailing address
7040 Lake Ellenor Dr
Orlando, FL 32809-5750
Phone (407) 858-6143
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 |
|---|---|---|---|
| RN 9286049 | FL | MD | Pediatric Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251158400000",
"number": "1689807703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7040 LAKE ELLENOR DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328095750",
"telephone_number": "407-858-6143",
"fax_number": "407-856-6594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7040 LAKE ELLENOR DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328095750",
"telephone_number": "407-858-6143",
"fax_number": "407-856-6594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTERKIN",
"first_name": "JACQUELINE",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-25",
"last_updated": "2009-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": "FL",
"license": "RN 9286049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.