Individual provider Active NPI

Sophonie Moise

  • Registered Nurse
  • Saint Albans, NY
National Provider Identifier
1093398372
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
807794 Issued in NY
Practice address
11515 204TH St
Saint Albans, NY 11412-2818
Phone
(516) 851-6422
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 807794 NY Primary

Addresses

Primary practice location

11515 204TH St
Saint Albans, NY 11412-2818

Mailing address

11515 204TH St
Saint Albans, NY 11412-2818
Phone (516) 851-6422

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
807794NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1093398372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 204TH ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122818",
            "telephone_number": "516-851-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 204TH ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122818",
            "telephone_number": "516-851-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISE",
        "first_name": "SOPHONIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "807794",
            "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 May 4, 2021; 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.