Nepenthe Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

01467110 Issued in NY

Legal business name

NEPENTHE INC

Practice address

435 Brook Ave
Unit 29
Deer Park, NY 11729-6829

Phone

(631) 243-3056

Fax

(631) 243-3132

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rosanne M Mirando

Title

Medical Biller

Phone

(631) 243-3056

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184776908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 BROOK AVE",
            "address_2": "UNIT 29",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296829",
            "telephone_number": "631-243-3056",
            "fax_number": "631-243-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 BROOK AVE",
            "address_2": "UNIT 29",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296829",
            "telephone_number": "631-243-3056",
            "fax_number": "631-243-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPENTHE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIRANDO",
        "authorized_official_first_name": "ROSANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "631-243-3056",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "01467110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01467110",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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