Individual provider Active NPI

Stacey Surrency

  • Registered Nurse
  • West Babylon, NY
National Provider Identifier
1043587744
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
407132-1 Issued in NY
Practice address
50 Silver St
West Babylon, NY 11704-3925
Phone
(631) 427-0311
Fax
(631) 623-4934
NPI assigned
Nov 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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 407132-1 NY Primary

Addresses

Primary practice location

50 Silver St
West Babylon, NY 11704-3925

Mailing address

50 Silver St
West Babylon, NY 11704-3925
Phone (631) 427-0311

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
407132-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1043587744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SILVER ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117043925",
            "telephone_number": "631-427-0311",
            "fax_number": "631-623-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SILVER ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117043925",
            "telephone_number": "631-427-0311",
            "fax_number": "631-623-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRENCY",
        "first_name": "STACEY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "407132-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.