Individual provider Active NPI

Terricka Pontoon

  • Licensed Practical Nurse
  • Arverne, NY
National Provider Identifier
1114332673
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
285766 Issued in NY
Practice address
5481 Almeda Ave
6D
Arverne, NY 11692-1534
Phone
(516) 324-9914
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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 285766 NY Primary

Addresses

Primary practice location

5481 Almeda Ave
6D
Arverne, NY 11692-1534

Mailing address

5481 Almeda Ave
6D
Arverne, NY 11692-1534
Phone (516) 324-9914

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
285766NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1114332673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5481 ALMEDA AVE",
            "address_2": "6D",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921534",
            "telephone_number": "516-324-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5481 ALMEDA AVE",
            "address_2": "6D",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921534",
            "telephone_number": "516-324-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTOON",
        "first_name": "TERRICKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "285766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arverne, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.