Active NPI
Patricia Ellen Barry, RN
- Registered Nurse
- East Northport, NY
National Provider Identifier
1124214515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 532293
- Practice address
- 12 Kimberly Drive
East Northport, NY 11731 - Phone
- (631) 368-7286
- Fax
- (631) 980-3539
- NPI assigned
- Sep 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 532293 | NY | Primary |
Addresses
Primary practice location
12 Kimberly Drive
East Northport, NY 11731
Mailing address
145 Ave C
Holbrook, NY 11741
Phone (631) 909-3676
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02352050 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 532293 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1124214515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 AVE C",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "11741",
"telephone_number": "631-909-3676",
"fax_number": "631-909-3676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 KIMBERLY DRIVE",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "11731",
"telephone_number": "631-368-7286",
"fax_number": "631-980-3539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRY",
"first_name": "PATRICIA",
"middle_name": "ELLEN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "532293",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02352050",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.