Cheyenne Slack, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

340734 Issued in NY

Practice address

23 Brittany CT
Northport, NY 11768-3225

Phone

(631) 834-5420

NPI assigned

Feb 5, 2021

Last updated

Sep 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1386236818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 N PARK AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BRITTANY CT",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683225",
            "telephone_number": "631-834-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "CHEYENNE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "340734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "12345678",
            "identifier": "12345678",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK",
            "identifier": "340734",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cheyennecolleen@gmail.com",
            "affiliation": "N",
            "address_1": "23 Brittany Ct",
            "city": "Northport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117683225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cheyennecolleen@gmail.com",
            "affiliation": "N",
            "address_1": "23 Brittany Ct",
            "city": "Northport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117683225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erika Lee Silverstein
• Lakhvir Singh, M.D.
• Mandeep Singh, M.D
• Amalia Rose Sirica, LCSW
• Michael B Sklar, NP
• Richard David Sloan, MS, P.DIPL., CRC
• Carol Smith, NP
• Kimberly Ann Smith, PHARM.D.
• Ralph Kurt Smith, MS ED. CRC
• Melissa Snyder, LCSW

• Licensed Practical Nurse in Northport, NY
• Providers in Northport, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.