Individual provider Active NPI

Brenda Joyce Klingel, RN

  • Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1518159425
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
233447-1 Issued in NY
Practice address
5 Hother LN
Bay Shore, NY 11706-7622
Phone
(631) 665-2642
NPI assigned
Aug 14, 2007
Last updated
Aug 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 233447-1 NY Primary

Addresses

Primary practice location

5 Hother LN
Bay Shore, NY 11706-7622

Mailing address

5 Hother LN
Bay Shore, NY 11706-7622
Phone (631) 665-2642

Other identifiers 1

IdentifierTypeStateIssuer
01279547OtherNYPRIVATE PROVIDER NUMBER

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
233447-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1518159425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HOTHER LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067622",
            "telephone_number": "631-665-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HOTHER LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067622",
            "telephone_number": "631-665-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGEL",
        "first_name": "BRENDA",
        "middle_name": "JOYCE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "233447-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PROVIDER NUMBER",
            "identifier": "01279547",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.