Individual provider Active NPI

Mardeika Amalethea Dunn, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1275018616
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
617856 Issued in NY
Practice address
900 Intervale Ave
Bronx, NY 10459-4240
Phone
(646) 287-0856
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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 617856 NY Primary

Addresses

Primary practice location

900 Intervale Ave
Bronx, NY 10459-4240

Mailing address

1 Linden St Apt A1
Norwalk, CT 06851-1516

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
617856NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1275018616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LINDEN ST APT A1",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 INTERVALE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104594240",
            "telephone_number": "646-287-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "MARDEIKA",
        "middle_name": "AMALETHEA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "617856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.