Individual provider Active NPI

Royke Rantung

  • Registered Nurse
  • Grand Terrace, CA
National Provider Identifier
1700486396
Registry record updated Oct 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95230241 Issued in CA
Practice address
22431 Terrace Pines Dr Apt D
Grand Terrace, CA 92313-5059
Phone
(909) 572-0472
NPI assigned
Oct 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95230241 CA Primary

Addresses

Primary practice location

22431 Terrace Pines Dr Apt D
Grand Terrace, CA 92313-5059

Mailing address

22431 Terrace Pines Dr Apt D
Grand Terrace, CA 92313-5059

Other names 1

  • Roy Rantung Other name

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

LicenseStateTypeSpecialty
95230241CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1604102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604102400000",
    "number": "1700486396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22431 TERRACE PINES DR APT D",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22431 TERRACE PINES DR APT D",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135059",
            "telephone_number": "909-572-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANTUNG",
        "first_name": "ROYKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-31",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95230241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROY",
            "last_name": "RANTUNG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Terrace, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2020; 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.