Individual provider Active NPI

Kyle Sugonis, RN

  • Registered Nurse
  • Salem, VA
National Provider Identifier
1043050347
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9410985 Issued in FL
Practice address
1970 Roanoke Blvd
Salem, VA 24153-6404
Phone
(540) 982-2463
NPI assigned
May 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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 RN9410985 FL Primary

Addresses

Primary practice location

1970 Roanoke Blvd
Salem, VA 24153-6404

Mailing address

2024 SW 29TH Ter
Cape Coral, FL 33914-2903
Phone (304) 633-9178

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
RN9410985FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1043050347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 SW 29TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339142903",
            "telephone_number": "304-633-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGONIS",
        "first_name": "KYLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9410985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; 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.