Individual provider Active NPI

Joyce Linda Edel, R.N.

  • Registered Nurse
  • Port Jefferson, NY
National Provider Identifier
1013229764
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
367003-1 Issued in NY
Practice address
1 Dark Hollow Rd
Apt 4a
Port Jefferson, NY 11777-2049
Phone
(631) 828-5399
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 367003-1 NY Primary
Registered Nurse 163W00000X 101865 SC

Addresses

Primary practice location

1 Dark Hollow Rd
Apt 4a
Port Jefferson, NY 11777-2049

Mailing address

1 Dark Hollow Rd
Apt 4a
Port Jefferson, NY 11777-2049
Phone (631) 828-5399

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
367003-1NYMDRegistered Nurse
101865SCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1013229764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DARK HOLLOW RD",
            "address_2": "APT 4A",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772049",
            "telephone_number": "631-828-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DARK HOLLOW RD",
            "address_2": "APT 4A",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772049",
            "telephone_number": "631-828-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEL",
        "first_name": "JOYCE",
        "middle_name": "LINDA",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "367003-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "101865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.