Individual provider Active NPI

Bredgette Marie Parker, RN

  • Registered Nurse
  • Suffern, NY
National Provider Identifier
1124519467
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
736446 Issued in NY
Practice address
15 Suffern Place
Suffern, NY 10901
Phone
(845) 357-4500
Fax
(845) 357-5039
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2018

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 736446 NY Primary

Addresses

Primary practice location

15 Suffern Place
Suffern, NY 10901

Mailing address

15 Suffern Place
Suffern, NY 10901
Phone (845) 357-4500

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

LicenseStateTypeSpecialty
736446NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1124519467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PLACE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-4500",
            "fax_number": "845-357-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PLACE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-4500",
            "fax_number": "845-357-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BREDGETTE",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "736446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.