Organization Active NPI

Personnel Healthcare Management, LLC

  • Gerontology Nurse Practitioner
  • Freeport, NY
National Provider Identifier
1386072833
Registry record updated Oct 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F340165 Issued in NY
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

Updated by the provider on Oct 20, 2013

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)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
01917082MedicaidNY

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.