Individual provider Active NPI

Susan Yvette Sampson-Jordan

  • School Registered Nurse
  • Laurelton, NY
National Provider Identifier
1407723661
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
882009-01 Issued in NY
Practice address
13041 224TH St
Laurelton, NY 11413-1245
Phone
(347) 458-5465
Fax
(347) 529-1993
NPI assigned
Oct 22, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 882009-01 NY Primary

Addresses

Primary practice location

13041 224TH St
Laurelton, NY 11413-1245

Mailing address

13041 224TH St
Laurelton, NY 11413-1245
Phone (347) 458-5465

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
882009-01NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1407723661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13041 224TH ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114131245",
            "telephone_number": "347-458-5465",
            "fax_number": "347-529-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13041 224TH ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114131245",
            "telephone_number": "347-458-5465",
            "fax_number": "347-529-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON-JORDAN",
        "first_name": "SUSAN",
        "middle_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "882009-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurelton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.