NPIMap

Organization Active NPI

Dunderty Enterprise LLC

  • Case Manager/Care Coordinator
  • Brentwood, NY
National Provider Identifier
1104469451
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
DUNDERTY ENTERPRISE LLC
Doing business as
dunDerty Enterprise
Practice address
119 Thomas St
Brentwood, NY 11717-1218
Phone
(770) 713-9158
NPI assigned
Oct 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Authorized official

Name
Gerald Jordan, MS
Title
Ceo
Phone
(770) 713-9158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X Primary

Addresses

Primary practice location

119 Thomas St
Brentwood, NY 11717-1218

Mailing address

119 Thomas St
Brentwood, NY 11717-1218
Phone (770) 713-9158

Other names 1

  • dunDerty Enterprise Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dunderty Enterprise2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571356800000",
    "number": "1104469451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 THOMAS ST",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171218",
            "telephone_number": "770-713-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 THOMAS ST",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171218",
            "telephone_number": "770-713-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNDERTY ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-713-9158",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dunDerty Enterprise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.