Individual provider Active NPI

Roxanne M Patterson, LPN

  • Licensed Practical Nurse
  • Plymouth Meeting, PA
National Provider Identifier
1205017787
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN260770L Issued in PA
Practice address
2250 Hickory Road Suite 240
Plymouth Meeting, PA 19462
Phone
(180) 087-9447
Fax
(610) 834-7525
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN260770L PA Primary

Addresses

Primary practice location

2250 Hickory Road Suite 240
Plymouth Meeting, PA 19462

Mailing address

1054 Chestnut St
Phila, PA 19023
Phone (610) 733-6039

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
PN260770LPAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1205017787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 CHESTNUT ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19023",
            "telephone_number": "610-733-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY ROAD SUITE 240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "19462",
            "telephone_number": "180-087-9447",
            "fax_number": "610-834-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "ROXANNE",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN260770L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.