Wanda Socorro Betancourt Rivera, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

28217649A Issued in IN

Practice address

2015 W Western Ave Ste 132
South Bend, IN 46619-3561

Phone

(574) 327-0140

NPI assigned

May 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Other names 1

• Wanda S Betancourt Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Heaven Sent Home Health Systems

  • Registered Nurse
  • South Bend, IN
  • NPI 1407386071
  NPD (past)

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1740637370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 W WESTERN AVE",
            "address_2": "SUITE 132",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466193544",
            "telephone_number": "574-229-8749",
            "fax_number": "574-855-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W WESTERN AVE STE 132",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466193561",
            "telephone_number": "574-327-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT RIVERA",
        "first_name": "WANDA",
        "middle_name": "SOCORRO",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "IN",
            "license": "28217649A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28217649A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "BETANCOURT",
            "middle_name": "S",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anna C. Berzai, RD
• Scott Berzai
• Consolacion A Besario, RPT
• Jennifer N Besemer, RD, CDE
• Stacy Beshara, PT
• Kaelah Bethany
• Kenndall Bethel
• Better Living Home Care
• Hannah Betz, BCBA
• Elizabeth A. Bevis

• Registered Nurse in South Bend, IN
• Providers in South Bend, IN by specialty
• Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.