Individual provider Active NPI

Nadine N Vaughan-Davis, MSW CANDIDATE

  • Student in an Organized Health Care Education/Training Program
  • Elmont, NY
National Provider Identifier
1376616458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
570 Elmont Rd
Elmont, NY 11003-3535
Phone
(516) 437-6050
Fax
(516) 437-6304
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

570 Elmont Rd
Elmont, NY 11003-3535

Mailing address

570 Elmont Rd
Elmont, NY 11003-3535
Phone (516) 437-6050

Other identifiers 1

IdentifierTypeStateIssuer
01666971MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family and Children'S Association - Linkage Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376616458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033535",
            "telephone_number": "516-437-6050",
            "fax_number": "516-437-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033535",
            "telephone_number": "516-437-6050",
            "fax_number": "516-437-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN-DAVIS",
        "first_name": "NADINE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "MSW CANDIDATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01666971",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.