Active NPI
Denese Helen Preddie
- Specialist
- Port St Lucie, FL
National Provider Identifier
1902140627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 6906485
- Practice address
- 1066 SW Cairo Ave
Port St Lucie, FL 34953 - Phone
- (772) 237-5647
- Fax
- (772) 237-5800
- NPI assigned
- Nov 19, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 6906485 | FL | Primary |
Addresses
Primary practice location
1066 SW Cairo Ave
Port St Lucie, FL 34953
Mailing address
1066 SW Cairo Ave
Port St Lucie, FL 34953
Phone (772) 237-5647
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 |
|---|---|---|---|
| 6906485 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1902140627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1066 SW CAIRO AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "34953",
"telephone_number": "772-237-5647",
"fax_number": "772-237-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1066 SW CAIRO AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "34953",
"telephone_number": "772-237-5647",
"fax_number": "772-237-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREDDIE",
"first_name": "DENESE",
"middle_name": "HELEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-19",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "6906485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
- Catherine Alice Prann, D.C.
- Jessica Anne Pratt, PTA
- Precious Moments Assisted Living Facility LLC
- Precise Care Services
- Precision Diagnostic of Port St Lucie LLC
- Preferred Private Care, LLC
- Premier Physical Therapy Sport Medicine Inc
- Premier Physical Therapy Sport Medicine Inc
- Premier Spine Specialists, LLC
- Premier Surgical Assisting LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.