Individual provider Active NPI

Patricia Lillian Hargrave, R.N.

  • Registered Nurse
  • Mahopac, NY
National Provider Identifier
1275784688
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
454862-1 Issued in NY
Practice address
82 Lakeside Rd
Mahopac, NY 10541-3125
Phone
(845) 628-3828
NPI assigned
Oct 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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 454862-1 NY Primary

Addresses

Primary practice location

82 Lakeside Rd
Mahopac, NY 10541-3125

Mailing address

82 Lakeside Rd
Mahopac, NY 10541-3125
Phone (845) 628-3828

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
454862-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1275784688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 LAKESIDE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105413125",
            "telephone_number": "845-628-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 LAKESIDE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105413125",
            "telephone_number": "845-628-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGRAVE",
        "first_name": "PATRICIA",
        "middle_name": "LILLIAN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "454862-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.