Individual provider Active NPI

Dinette Phildor

  • Continence Care Registered Nurse
  • Laurelton, NY
National Provider Identifier
1477012839
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Continence Care Registered NurseTaxonomy code 163WC2100X
License
602424 Issued in NY
Practice address
13545 223Rd St
Laurelton, NY 11413-2341
Phone
(917) 767-2227
NPI assigned
Mar 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 602424 NY
Continence Care Registered Nurse 163WC2100X 602424 NY Primary
Administrator Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WA2000X 602424 NY

Addresses

Primary practice location

13545 223Rd St
Laurelton, NY 11413-2341

Mailing address

13545 223Rd St
Laurelton, NY 11413-2341
Phone (917) 767-2227

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
602424NYMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1477012839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13545 223RD ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132341",
            "telephone_number": "917-767-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13545 223RD ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132341",
            "telephone_number": "917-767-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILDOR",
        "first_name": "DINETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "602424",
            "primary": false
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "NY",
            "license": "602424",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "602424",
            "primary": false
        }
    ],
    "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 Mar 15, 2019; 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.