Individual provider Active NPI

Kathleen A Osullivan, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1316255763
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
476642-1 Issued in NY
Practice address
475 West 250 St
Bronx, NY 10471-2103
Phone
(718) 549-4753
Fax
(718) 796-6474
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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 476642-1 NY Primary

Addresses

Primary practice location

475 West 250 St
Bronx, NY 10471-2103

Mailing address

5627 Delafield Ave
Bronx, NY 10471-2103
Phone (718) 884-1496

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
476642-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1316255763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 DELAFIELD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712103",
            "telephone_number": "718-884-1496",
            "fax_number": "718-548-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WEST 250 ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712103",
            "telephone_number": "718-549-4753",
            "fax_number": "718-796-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSULLIVAN",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "476642-1",
            "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 Sep 20, 2010; 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.