Active NPI
Heidy L Dorgerville, LPN
- Licensed Practical Nurse
- Saint Albans, NY
National Provider Identifier
1083909014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 305314
- Practice address
- 20514 Linden Blvd
Saint Albans, NY 11412-2900 - Phone
- (718) 528-5493
- Fax
- (718) 525-4305
- NPI assigned
- Jun 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 305314 | NY | Primary |
Addresses
Primary practice location
20514 Linden Blvd
Saint Albans, NY 11412-2900
Mailing address
20514 Linden Blvd
Saint Albans, NY 11412-2900
Phone (718) 528-5493
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
| License | State | Type | Specialty |
|---|---|---|---|
| 305314 | NY | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308268800000",
"number": "1083909014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20514 LINDEN BLVD",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122900",
"telephone_number": "718-528-5493",
"fax_number": "718-525-4305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20514 LINDEN BLVD",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122900",
"telephone_number": "718-528-5493",
"fax_number": "718-525-4305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORGERVILLE",
"first_name": "HEIDY",
"middle_name": "L",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-17",
"last_updated": "2011-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "305314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Albans, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.