Individual provider Active NPI

Christa Lafortune

  • Licensed Practical Nurse
  • Ronkonkoma, NY
National Provider Identifier
1174137764
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
337493-01 Issued in NY
Practice address
117 Patchogue Holbrook Rd
Ronkonkoma, NY 11779-5721
Phone
(516) 234-8291
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 337493-01 NY Primary

Addresses

Primary practice location

117 Patchogue Holbrook Rd
Ronkonkoma, NY 11779-5721

Mailing address

117 Patchogue Holbrook Rd
Ronkonkoma, NY 11779-5721
Phone (516) 234-8291

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
337493-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1174137764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 PATCHOGUE HOLBROOK RD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117795721",
            "telephone_number": "516-234-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 PATCHOGUE HOLBROOK RD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117795721",
            "telephone_number": "516-234-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFORTUNE",
        "first_name": "CHRISTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "337493-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.