Individual provider Active NPI

Kristen L Maher

  • Licensed Practical Nurse
  • East Patchogue, NY
National Provider Identifier
1235874686
Registry record updated Apr 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
1474728 Issued in NY
Practice address
32 La Bonne Vie Dr Apt C
East Patchogue, NY 11772-4430
Phone
(516) 462-0786
NPI assigned
Apr 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2022

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 1474728 NY Primary

Addresses

Primary practice location

32 La Bonne Vie Dr Apt C
East Patchogue, NY 11772-4430

Mailing address

32 La Bonne Vie Dr Apt C
East Patchogue, NY 11772-4430
Phone (516) 462-0786

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
1474728NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651276800000",
    "number": "1235874686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 LA BONNE VIE DR APT C",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724430",
            "telephone_number": "516-462-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 LA BONNE VIE DR APT C",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724430",
            "telephone_number": "516-462-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-30",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "1474728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2022; 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.