Individual provider Active NPI

Donna Roxanne Clarke, L.P.N.

  • Licensed Practical Nurse
  • Far Rockaway, NY
National Provider Identifier
1093931362
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
275963-1 Issued in NY
Practice address
316 Beach 65TH St
Far Rockaway, NY 11692-1425
Phone
(718) 474-3800
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 275963-1 NY Primary

Addresses

Primary practice location

316 Beach 65TH St
Far Rockaway, NY 11692-1425

Mailing address

9434 112TH St
South Richmond Hill, NY 11419-1104
Phone (917) 478-7228

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
275963-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Daytop Village, Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093931362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9434 112TH ST",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191104",
            "telephone_number": "917-478-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 BEACH 65TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116921425",
            "telephone_number": "718-474-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DONNA",
        "middle_name": "ROXANNE",
        "name_prefix": "Ms.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "275963-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.