Active NPI
Personnel Healthcare Management, LLC
- Gerontology Nurse Practitioner
- Freeport, NY
National Provider Identifier
1386072833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- F340165
- Legal business name
- PERSONNEL HEALTHCARE MANAGEMENT, LLC
- Practice address
- 91 Washburn Ave
Freeport, NY 11520-2308 - Phone
- (516) 867-5111
- NPI assigned
- Oct 20, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pangeta McGrowther Ferguson, NP
- Title
- Owner
- Phone
- (516) 867-5111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | F340165 | NY | Primary |
Addresses
Primary practice location
91 Washburn Ave
Freeport, NY 11520-2308
Mailing address
91 Washburn Ave
Freeport, NY 11520-2308
Phone (516) 867-5111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01917082 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382227200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1382227200000",
"number": "1386072833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 WASHBURN AVE",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115202308",
"telephone_number": "516-867-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 WASHBURN AVE",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115202308",
"telephone_number": "516-867-5111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERSONNEL HEALTHCARE MANAGEMENT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-10-20",
"last_updated": "2013-10-20",
"status": "A",
"authorized_official_last_name": "MCGROWTHER FERGUSON",
"authorized_official_first_name": "PANGETA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "516-867-5111",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": "NY",
"license": "F340165",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01917082",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.