Individual provider Active NPI

Veda Tyson, NP-P, LMSW, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1083731665
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401299 Issued in NY
Practice address
138 W 25TH St
New York, NY 10001-7405
Phone
(212) 335-2100
Fax
(646) 775-4142
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4524 CT
Clinical Social Worker 1041C0700X 68378 NY
Registered Nurse 163W00000X 628862 NY
Registered Nurse 163W00000X 088298 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401299 NY Primary

Addresses

Primary practice location

138 W 25TH St
New York, NY 10001-7405

Mailing address

138 W 25TH St
New York, NY 10001-7405
Phone (212) 335-2100

Other practice location 1

180 S Broadway Ste 310
White Plains, NY 10605-1820
Phone (914) 259-5770

Other practice location 2

73 Market St
Yonkers, NY 10710-7616
Phone (914) 848-8030

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
68378NYMDClinical Social Worker
088298CTMDRegistered Nurse
628862NYMDRegistered Nurse
4524CTMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1083731665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "212-335-2100",
            "fax_number": "646-775-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "212-335-2100",
            "fax_number": "646-775-4142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 S Broadway Ste 310",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106051820",
            "country_code": "US",
            "telephone_number": "914-259-5770",
            "fax_number": "914-206-3537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Market St",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107107616",
            "country_code": "US",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYSON",
        "first_name": "VEDA",
        "name_prefix": "Ms.",
        "credential": "NP-P, LMSW, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "4524",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "68378",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "628862",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "088298",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.