Individual provider Active NPI

Jennifer Murillo, NP

  • Adult Health Nurse Practitioner
  • Harrison, NY
National Provider Identifier
1447672340
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311319-01 Issued in NY
Practice address
440 Mamaroneck Ave
Harrison, NY 10528-2418
Phone
(855) 871-0841
NPI assigned
Jan 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 617191 NY
Adult Health Nurse Practitioner 363LA2200X F311319-01 NY Primary

Addresses

Primary practice location

440 Mamaroneck Ave
Harrison, NY 10528-2418

Mailing address

5854 207TH St
Oakland Gardens, NY 11364-1731

Other practice location 1

3711 Queens Blvd
NY Hotel Trades Council Queens Health Center
Long Island City, NY 11101-1725
Phone (718) 361-5100

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
617191NYMDAmbulatory Care Registered Nurse
F311319-01NYMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jennifermurillo@nslijmedgr.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1447672340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5854 207TH ST",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113641731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MAMARONECK AVE",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282418",
            "telephone_number": "855-871-0841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3711 Queens Blvd",
            "address_2": "NY Hotel Trades Council Queens Health Center",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111011725",
            "country_code": "US",
            "telephone_number": "718-361-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURILLO",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "617191",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311319-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.