Individual provider Active NPI

Simone Patterson

  • Registered Nurse
  • Jamaica, NY
National Provider Identifier
1194138396
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
684345-1 Issued in NY
Practice address
16933 144TH Rd
Jamaica, NY 11434-5929
Phone
(718) 978-7221
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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 684345-1 NY Primary

Addresses

Primary practice location

16933 144TH Rd
Jamaica, NY 11434-5929

Mailing address

16933 144TH Rd
Jamaica, NY 11434-5929
Phone (718) 978-7221

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
684345-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1194138396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16933 144TH RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345929",
            "telephone_number": "718-978-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16933 144TH RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345929",
            "telephone_number": "718-978-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "SIMONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "684345-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.