Individual provider Active NPI

Kathleen Ann Sweeney

  • Licensed Practical Nurse
  • Sound Beach, NY
National Provider Identifier
1083846067
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
246229-1 Issued in NY
Practice address
12 Mastic Rd
Sound Beach, NY 11789-1726
Phone
(631) 807-9659
Fax
(631) 849-3154
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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 246229-1 NY Primary

Addresses

Primary practice location

12 Mastic Rd
Sound Beach, NY 11789-1726

Mailing address

12 Mastic Rd
Sound Beach, NY 11789-1726
Phone (631) 807-9659

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
246229-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1083846067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MASTIC RD",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117891726",
            "telephone_number": "631-807-9659",
            "fax_number": "631-849-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MASTIC RD",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117891726",
            "telephone_number": "631-807-9659",
            "fax_number": "631-849-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "246229-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sound Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.