Individual provider Active NPI

Roberta Johashen

  • Registered Nurse
  • Freeport, NY
National Provider Identifier
1033652946
Registry record updated Nov 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
22540340 Issued in NY
Practice address
248 Grand Ave
Freeport, NY 11520-2422
Phone
(516) 244-6159
NPI assigned
Nov 24, 2016
Last updated
Nov 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 22540340 NY Primary

Addresses

Primary practice location

248 Grand Ave
Freeport, NY 11520-2422

Mailing address

248 Grand Ave
Freeport, NY 11520-2422
Phone (516) 244-6159

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
22540340NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1479945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479945600000",
    "number": "1033652946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 GRAND AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202422",
            "telephone_number": "516-244-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 GRAND AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202422",
            "telephone_number": "516-244-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHASHEN",
        "first_name": "ROBERTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-24",
        "last_updated": "2016-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22540340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2016; 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.