Individual provider Active NPI

Dianne Harris, RN

  • School Registered Nurse
  • Mount Vernon, NY
National Provider Identifier
1104102680
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
627254 Issued in NY
Practice address
24 W Kingsbridge Rd
Mount Vernon, NY 10550-4945
Phone
(646) 431-5057
NPI assigned
Oct 27, 2011
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 627254 NY Primary

Addresses

Primary practice location

24 W Kingsbridge Rd
Mount Vernon, NY 10550-4945

Mailing address

24 W Kingsbridge Rd
Bronx, NY 10468-7506
Phone (646) 431-5057

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
627254NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1104102680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 W KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104687506",
            "telephone_number": "646-431-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 W KINGSBRIDGE RD",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504945",
            "telephone_number": "646-431-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DIANNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "627254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

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

Verify at the official NPI Registry.