Individual provider Active NPI

Patrice Nattalie Johnson, REGISTERED NURSE

  • Registered Nurse
  • New Rochelle, NY
National Provider Identifier
1154989135
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
554185-1 Issued in NY
Practice address
173 Huguenot Street
Ste 213
New Rochelle, NY 10801-1080
Phone
(914) 334-6512
Fax
(914) 999-6101
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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 554185-1 NY Primary

Addresses

Primary practice location

173 Huguenot Street
Ste 213
New Rochelle, NY 10801-1080

Mailing address

40 Memorial Hwy Apt 24D
New Rochelle, NY 10801-8337
Phone (914) 316-1598

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
554185-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kind Loyal Service RN Healthcare Services PLLC Current Accepting new patients

Locations

173 Huguenot St
Ste 213
New Rochelle, NY 10801
Phone (914) 334-6512

Organizations & group practices 1

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1154989135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MEMORIAL HWY APT 24D",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108018337",
            "telephone_number": "914-316-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 HUGUENOT STREET",
            "address_2": "STE 213",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108011080",
            "telephone_number": "914-334-6512",
            "fax_number": "914-999-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICE",
        "middle_name": "NATTALIE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "554185-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.