Individual provider Active NPI

Regina Alvarez, LPN

  • Licensed Practical Nurse
  • Port Jefferson, NY
National Provider Identifier
1104073626
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
150165 Issued in NY
Practice address
107 Glenwood LN
Port Jefferson, NY 11777-1504
Phone
(631) 828-8416
NPI assigned
Aug 27, 2008
Last updated
Aug 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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 150165 NY Primary

Addresses

Primary practice location

107 Glenwood LN
Port Jefferson, NY 11777-1504

Mailing address

107 Glenwood LN
Port Jefferson, NY 11777-1504
Phone (631) 828-8416

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

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1104073626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GLENWOOD LN",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771504",
            "telephone_number": "631-828-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 GLENWOOD LN",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771504",
            "telephone_number": "631-828-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "REGINA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "150165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.