Individual provider Active NPI

Renae Jean O'Keeffe, NP

  • Family Nurse Practitioner
  • Isla Vista, CA
National Provider Identifier
1871827295
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19096 Issued in CA
Practice address
970 Embarcadero del Mar
Isla Vista, CA 93117-4887
Phone
(805) 968-1511
Fax
(805) 968-7041
NPI assigned
Oct 1, 2009
Last updated
May 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19096 CA Primary

Addresses

Primary practice location

970 Embarcadero del Mar
Isla Vista, CA 93117-4887

Mailing address

915 N Milpas St
2ND Floor
Santa Barbara, CA 93103-2331
Phone (805) 617-7858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908000663 CA Practitioner - Nurse Practitioner 1759677362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19096CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trucare Medical Corporation CurrentSince Oct 1, 2019 Accepting new patients

Locations

1234 W Chapman Ave
Ste 101
Orange, CA 92868
Phone (714) 223-0883

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1871827295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N MILPAS ST",
            "address_2": "2ND FLOOR",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931032331",
            "telephone_number": "805-617-7858",
            "fax_number": "805-963-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 EMBARCADERO DEL MAR",
            "city": "ISLA VISTA",
            "state": "CA",
            "postal_code": "931174887",
            "telephone_number": "805-968-1511",
            "fax_number": "805-968-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFFE",
        "first_name": "RENAE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isla Vista, CA

Sources for this page

Verify at the official NPI Registry.