Individual provider Active NPI

Kelly Messineo, LPN

  • Licensed Practical Nurse
  • Wurtsboro, NY
National Provider Identifier
1356714208
Registry record updated Nov 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
10310839 Issued in NY
Practice address
120 Pine St
Wurtsboro, NY 12790-8206
Phone
(845) 796-6887
NPI assigned
Nov 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 10310839 NY Primary

Addresses

Primary practice location

120 Pine St
Wurtsboro, NY 12790-8206

Mailing address

PO Box 461
Wurtsboro, NY 12790-0461
Phone (845) 796-6887

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
10310839NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1446336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446336000000",
    "number": "1356714208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461",
            "city": "WURTSBORO",
            "state": "NY",
            "postal_code": "127900461",
            "telephone_number": "845-796-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PINE ST",
            "city": "WURTSBORO",
            "state": "NY",
            "postal_code": "127908206",
            "telephone_number": "845-796-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSINEO",
        "first_name": "KELLY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-01",
        "last_updated": "2015-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10310839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wurtsboro, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2015; 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.