Individual provider Active NPI

June Smith

  • Registered Nurse
  • Kings Park, NY
National Provider Identifier
1124457056
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
553814 Issued in NY
Practice address
25 Daisy Dr
Kings Park, NY 11754-3209
Phone
(631) 513-7924
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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 553814 NY Primary

Addresses

Primary practice location

25 Daisy Dr
Kings Park, NY 11754-3209

Mailing address

25 Daisy Dr
Kings Park, NY 11754-3209
Phone (631) 979-0368

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
553814NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Nursing Registry Inc. Past Accepting new patients
Christian Nursing Registry, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1124457056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 DAISY DR",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543209",
            "telephone_number": "631-979-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DAISY DR",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543209",
            "telephone_number": "631-513-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "553814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.