Individual provider Active NPI

Karen Constance Field, NURSE PRACTITIONER

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Medford, NY
National Provider Identifier
1497902506
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
F401135-1 Issued in NY
Practice address
12 Platinum CT
Ste C
Medford, NY 11763-2247
Phone
(631) 996-4430
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X F401135-1 NY Primary

Addresses

Primary practice location

12 Platinum CT
Ste C
Medford, NY 11763-2247

Mailing address

12 Platinum CT
Ste C
Medford, NY 11763-2247
Phone (631) 996-4430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 15, 2022 through Jul 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
401135NYMDRegistered Nurse
F401135-1NYMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Mia Center LLC Psychiatric/Mental Health, Adult CurrentSince Oct 5, 2021 Accepting new patients

Locations

12 Platinum Ct
Ste C
Medford, NY 11763
Phone (631) 996-4430

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1497902506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT",
            "address_2": "STE C",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-996-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT",
            "address_2": "STE C",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-996-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELD",
        "first_name": "KAREN",
        "middle_name": "CONSTANCE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "F401135-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.