Individual provider Active NPI

Jennifer Joyce Kratz, RN

  • Pediatric Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1265669873
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
541147 Issued in NY
Practice address
5 Hother LN
Bay Shore, NY 11706-7622
Phone
(479) 459-1809
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 541147 NY Primary

Addresses

Primary practice location

5 Hother LN
Bay Shore, NY 11706-7622

Mailing address

5 Hother LN
Bay Shore, NY 11706-7622
Phone (479) 459-1809

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
541147NYMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1265669873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HOTHER LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067622",
            "telephone_number": "479-459-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HOTHER LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067622",
            "telephone_number": "479-459-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATZ",
        "first_name": "JENNIFER",
        "middle_name": "JOYCE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "541147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.