Active NPI
Lynn Colagrande, LPN
- Licensed Practical Nurse
- Riverhead, NY
National Provider Identifier
1346657640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 286517-1
- Practice address
- 41 Forge Road Lot 9
Riverhead, NY 11901 - Phone
- (631) 655-5519
- NPI assigned
- Jul 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 286517-1 | NY | Primary |
Addresses
Primary practice location
41 Forge Road Lot 9
Riverhead, NY 11901
Mailing address
41 Forge Road Lot 9
Riverhead, NY 11901
Phone (631) 655-5519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164W00000X | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 286517-1 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405641600000",
"number": "1346657640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 FORGE ROAD LOT 9",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "11901",
"telephone_number": "631-655-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 FORGE ROAD LOT 9",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "11901",
"telephone_number": "631-655-5519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLAGRANDE",
"first_name": "LYNN",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-18",
"last_updated": "2014-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "286517-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164W00000X",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.