Individual provider Active NPI

Shaneice Wynter

  • Registered Nurse
  • Garden City, NY
National Provider Identifier
1104259613
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
675911 Issued in NY
Practice address
1 Education Drive
Garden City, NY 11530
Phone
(516) 506-8821
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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 675911 NY Primary

Addresses

Primary practice location

1 Education Drive
Garden City, NY 11530

Mailing address

1 Education Dr
Garden City, NY 11530-6719
Phone (516) 206-2222

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
675911NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1104259613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDUCATION DR",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115306719",
            "telephone_number": "516-206-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDUCATION DRIVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-506-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNTER",
        "first_name": "SHANEICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "675911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.