Individual provider Active NPI

Sharlene Edwards

  • Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1164811469
Registry record updated Jan 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
694850-1 Issued in NY
Practice address
13 Walbridge Ave
Bay Shore, NY 11706-3035
Phone
(631) 383-7225
NPI assigned
Jan 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2015

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 694850-1 NY Primary

Addresses

Primary practice location

13 Walbridge Ave
Bay Shore, NY 11706-3035

Mailing address

13 Walbridge Ave
Bay Shore, NY 11706-3035
Phone (631) 383-7225

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
694850-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1420848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420848000000",
    "number": "1164811469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 WALBRIDGE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063035",
            "telephone_number": "631-383-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 WALBRIDGE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063035",
            "telephone_number": "631-383-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SHARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-10",
        "last_updated": "2015-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "694850-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; 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.