Individual provider Active NPI

Beverly Leslie Parris-Fray, RN

  • Registered Nurse
  • Queens Village, NY
National Provider Identifier
1154569929
Registry record updated Feb 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
582542 Issued in NY
Practice address
22329 113TH Ave
Queens Village, NY 11429-2708
Phone
(917) 862-5215
Fax
(718) 347-4643
NPI assigned
Feb 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2009

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 582542 NY Primary

Addresses

Primary practice location

22329 113TH Ave
Queens Village, NY 11429-2708

Mailing address

22329 113TH Ave
Queens Village, NY 11429-2708
Phone (917) 862-5215

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
582542NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1233446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233446400000",
    "number": "1154569929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22329 113TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292708",
            "telephone_number": "917-862-5215",
            "fax_number": "718-347-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22329 113TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292708",
            "telephone_number": "917-862-5215",
            "fax_number": "718-347-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRIS-FRAY",
        "first_name": "BEVERLY",
        "middle_name": "LESLIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-01",
        "last_updated": "2009-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "582542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2009; 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.