Individual provider Active NPI

Rosemary Anne Smith, RN

  • Registered Nurse
  • Manorville, NY
National Provider Identifier
1083965511
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
654592 Issued in NY
Practice address
262 River Rd
Manorville, NY 11949-1402
Phone
(207) 290-0524
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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 654592 NY Primary
Registered Nurse 163W00000X RN61542 ME

Addresses

Primary practice location

262 River Rd
Manorville, NY 11949-1402

Mailing address

262 River Rd
P.O. Box 627
Manorville, NY 11949-1402
Phone (207) 290-0524

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN61542MEMDRegistered Nurse
654592NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1083965511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 RIVER RD",
            "address_2": "P.O. BOX 627",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119491402",
            "telephone_number": "207-290-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 RIVER RD",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119491402",
            "telephone_number": "207-290-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROSEMARY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "654592",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN61542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.