Individual provider Active NPI

Patricia Henry

  • Licensed Practical Nurse
  • Amityville, NY
National Provider Identifier
1043764137
Registry record updated Aug 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
322247 Issued in NY
Practice address
21 Walnut Rd
Amityville, NY 11701-1020
Phone
(631) 522-5619
NPI assigned
Aug 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 322247 NY Primary

Addresses

Primary practice location

21 Walnut Rd
Amityville, NY 11701-1020

Mailing address

21 Walnut Rd
Amityville, NY 11701-1020
Phone (631) 522-5619

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
322247NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1470528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470528000000",
    "number": "1043764137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WALNUT RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011020",
            "telephone_number": "631-522-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WALNUT RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011020",
            "telephone_number": "631-522-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-07",
        "last_updated": "2016-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "322247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.