Active NPI
Jan Marie Reddick, F.N.P.
- Family Nurse Practitioner
- Rohnert Park, CA
National Provider Identifier
1689880254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN270680
- Practice address
- 1801 E Cotati Ave
Rohnert Park, CA 94928-3613 - Phone
- (707) 664-2921
- Fax
- (707) 664-2925
- NPI assigned
- May 14, 2007
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN270680 | CA | Primary |
Addresses
Primary practice location
1801 E Cotati Ave
Rohnert Park, CA 94928-3613
Mailing address
1801 E Cotati Ave
Rohnert Park, CA 94928-3613
Phone (707) 664-2921
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 |
|---|---|---|---|
| RN270680 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Student Health Ctr Pharmacy | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Student Health Clinic/Center
- Rohnert Park, CA
- NPI 1699838763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689880254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 E COTATI AVE",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "949283613",
"telephone_number": "707-664-2921",
"fax_number": "707-664-2925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 E COTATI AVE",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "949283613",
"telephone_number": "707-664-2921",
"fax_number": "707-664-2925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDICK",
"first_name": "JAN",
"middle_name": "MARIE",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "RN270680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rohnert Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.