Individual provider Active NPI

Rita A Jeane

  • Durable Medical Equipment & Medical Supplies
  • Santa Fe, TX
National Provider Identifier
1902088552
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0041655 Issued in TX
Practice address
16526 Cowan Rd
Santa Fe, TX 77517-2769
Phone
(409) 789-8528
Fax
(409) 925-3904
NPI assigned
Dec 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0041655 TX Primary

Addresses

Primary practice location

16526 Cowan Rd
Santa Fe, TX 77517-2769

Mailing address

PO Box 103
Santa Fe, TX 77517-0103
Phone (409) 789-8528

Other identifiers 1

IdentifierTypeStateIssuer
016964101MedicaidTX

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
0041655TXMDDurable Medical Equipment & Medical Supplies

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1902088552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 103",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775170103",
            "telephone_number": "409-789-8528",
            "fax_number": "409-925-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16526 COWAN RD",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775172769",
            "telephone_number": "409-789-8528",
            "fax_number": "409-925-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANE",
        "first_name": "RITA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0041655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016964101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.