Individual provider Active NPI

Ellen Carol Raimomdo, REGISTERED NURSE

  • Registered Nurse
  • Kingston, NY
National Provider Identifier
1114101771
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
329962 Issued in NY
Practice address
366 Albany Ave
Kingston, NY 12401-2524
Phone
(845) 331-1966
Fax
(845) 331-7212
NPI assigned
Dec 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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 329962 NY Primary

Addresses

Primary practice location

366 Albany Ave
Kingston, NY 12401-2524

Mailing address

366 Albany Ave
Kingston, NY 12401-2524
Phone (845) 331-1966

Other identifiers 1

IdentifierTypeStateIssuer
329962OtherNYREGISTERED NURSE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Home Health Care & Companion Agency, 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": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1114101771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 ALBANY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012524",
            "telephone_number": "845-331-1966",
            "fax_number": "845-331-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 ALBANY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012524",
            "telephone_number": "845-331-1966",
            "fax_number": "845-331-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIMOMDO",
        "first_name": "ELLEN",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "329962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "329962",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.