Miguel A Medina Ventura, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

908783 Issued in TX

Practice address

20309 Fieldtree Dr
Humble, TX 77338-2344

Phone

(832) 795-1305

NPI assigned

Jun 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1811556756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20309 FIELDTREE DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773382344",
            "telephone_number": "832-795-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20309 FIELDTREE DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773382344",
            "telephone_number": "832-795-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA VENTURA",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "908783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "908783",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "medina@quantumsource.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20309 field dr",
            "city": "humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "77338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Humble, TX
• Providers in Humble, TX by specialty
• Psychiatric/Mental Health Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.