Individual provider Active NPI

Idalia Viard

  • Psychiatric/Mental Health Nurse Practitioner
  • Far Rockaway, NY
National Provider Identifier
1053883074
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1017344 Issued in TX
Practice address
610 Grassmere Ter
Far Rockaway, NY 11691-2535
Phone
(941) 587-6712
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 761298 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1017344 TX Primary

Addresses

Primary practice location

610 Grassmere Ter
Far Rockaway, NY 11691-2535

Mailing address

1400 Woodloch Forest Dr
The Woodlands, TX 77380-1100
Phone (941) 587-6712

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
761298NYMDRegistered Nurse
1017344TXMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1053883074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WOODLOCH FOREST DR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801100",
            "telephone_number": "941-587-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 GRASSMERE TER",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912535",
            "telephone_number": "941-587-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIARD",
        "first_name": "IDALIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "761298",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1017344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.