Individual provider Active NPI

Mirzana Calhoun

  • Licensed Practical Nurse
  • Port Chester, NY
National Provider Identifier
1407254063
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
320127-1 Issued in NY
Practice address
411 Westchester Ave 1-C
Port Chester, NY 10573
Phone
(914) 434-9996
NPI assigned
Dec 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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 320127-1 NY Primary

Addresses

Primary practice location

411 Westchester Ave 1-C
Port Chester, NY 10573

Mailing address

411 Westchester Ave Apt 1C
Port Chester, NY 10573-3723
Phone (914) 434-9996

Other names 1

  • Mirzana Ibrahimagic Former name

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
320127-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1407254063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WESTCHESTER AVE APT 1C",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733723",
            "telephone_number": "914-434-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WESTCHESTER AVE 1-C",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "10573",
            "telephone_number": "914-434-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "MIRZANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "320127-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRZANA",
            "last_name": "IBRAHIMAGIC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.