Individual provider Active NPI

Mzia Kvirkvelia

  • School Registered Nurse
  • Long Island City, NY
National Provider Identifier
1063817989
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
682856 Issued in NY
Practice address
2811 Queens PLZ N
5TH Floor
Long Island City, NY 11101-4008
Phone
(718) 391-8300
NPI assigned
Nov 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 682856 NY Primary

Addresses

Primary practice location

2811 Queens PLZ N
5TH Floor
Long Island City, NY 11101-4008

Mailing address

21 Holcomb Ave
Stamford, CT 06906-2412
Phone (917) 209-8522

Other names 1

  • Ms. Kimara Leveille Professional name

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
682856NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1063817989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HOLCOMB AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069062412",
            "telephone_number": "917-209-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 QUEENS PLZ N",
            "address_2": "5TH FLOOR",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014008",
            "telephone_number": "718-391-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVIRKVELIA",
        "first_name": "MZIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "682856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMARA",
            "last_name": "LEVEILLE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.