Active NPI
Renotta Jefferson
- Phlebology Physician
- Worton, MD
National Provider Identifier
1891489852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- S6K2D8M4
- Practice address
- 25054 Lambs Meadow Rd
Worton, MD 21678-1919 - Phone
- (443) 480-6608
- NPI assigned
- Jun 5, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | S6K2D8M4 | DE | Primary |
Addresses
Primary practice location
25054 Lambs Meadow Rd
Worton, MD 21678-1919
Mailing address
25054 Lambs Meadow Rd
Worton, MD 21678-1919
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 |
|---|---|---|---|
| S6K2D8M4 | DE | MD | Phlebology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renotta'S Gentle Hands Phlebotomy | Current | 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.
-
- Home Health Agency
- Worton, MD
- NPI 1134813967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685923200000",
"number": "1891489852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25054 LAMBS MEADOW RD",
"city": "WORTON",
"state": "MD",
"postal_code": "216781919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25054 LAMBS MEADOW RD",
"city": "WORTON",
"state": "MD",
"postal_code": "216781919",
"telephone_number": "443-480-6608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERSON",
"first_name": "RENOTTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-05",
"last_updated": "2023-06-05",
"certification_date": "2023-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "DE",
"license": "S6K2D8M4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.