Individual provider Active NPI

Iyatunde Garrett

  • Registered Nurse
  • Philadelphia, PA
National Provider Identifier
1033729561
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN561739 Issued in PA
Practice address
7615 Dickens Ave
Philadelphia, PA 19153-1310
Phone
(215) 617-8631
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 RN561739 PA Primary

Addresses

Primary practice location

7615 Dickens Ave
Philadelphia, PA 19153-1310

Mailing address

7615 Dickens Ave
Philadelphia, PA 19153-1310
Phone (215) 617-8631

Other identifiers 2

IdentifierTypeStateIssuer
210585439OtherPAHOME HEALTH AGENCY
210585439MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL creativealternativeservices@gmail.com

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
RN561739PAMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1033729561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 DICKENS AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191531310",
            "telephone_number": "215-617-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 DICKENS AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191531310",
            "telephone_number": "215-617-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "IYATUNDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN561739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "210585439",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210585439",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "creativealternativeservices@gmail.com",
            "affiliation": "Y",
            "endpointDescription": "creativealternativeservices@gmail.com",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7615 Dickens Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191531310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.

Verify at the official NPI Registry.