Individual provider Active NPI

Eboni T Marshall

  • Registered Nurse
  • Calverton, NY
National Provider Identifier
1346407780
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
641304-1 Issued in NY
Practice address
32 Wooded Way
Calverton, NY 11933
Phone
(631) 208-0343
NPI assigned
May 22, 2008
Last updated
Aug 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 641304-1 NY Primary
Continence Care Registered Nurse 163WC2100X 641304-1 NY
Diabetes Educator Registered Nurse 163WD0400X 641304-1 NY
Enterostomal Therapy Registered Nurse 163WE0900X 641304-1 NY
General Practice Registered Nurse 163WG0000X 641304-1 NY
Gastroenterology Registered Nurse 163WG0100X 641304-1 NY
Gerontology Registered Nurse 163WG0600X 641304-1 NY
Home Health Registered Nurse 163WH0200X 641304-1 NY
Hospice Registered Nurse 163WH1000X 641304-1 NY
Infusion Therapy Registered Nurse 163WI0500X 641304-1 NY
Medical-Surgical Registered Nurse 163WM0705X 641304-1 NY
Pediatric Registered Nurse 163WP0200X 641304-1 NY
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 641304-1 NY
Ostomy Care Registered Nurse 163WX1500X 641304-1 NY
Licensed Practical Nurse 164W00000X 2776121 NY

Addresses

Primary practice location

32 Wooded Way
Calverton, NY 11933

Mailing address

32 Wooded Way
Calverton, NY 11933
Phone (631) 208-0343

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
641304-1NYMDGastroenterology Registered Nurse
2776121NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1346407780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 WOODED WAY",
            "city": "CALVERTON",
            "state": "NY",
            "postal_code": "11933",
            "telephone_number": "631-208-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 WOODED WAY",
            "city": "CALVERTON",
            "state": "NY",
            "postal_code": "11933",
            "telephone_number": "631-208-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "EBONI",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "641304-1",
            "primary": true
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "NY",
            "license": "641304-1",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2776121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calverton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.