Individual provider Active NPI

Chamnong Nimnuan, L.P.N.

  • Licensed Practical Nurse
  • Rego Park, NY
National Provider Identifier
1528448362
Registry record updated Jun 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2966331 Issued in NY
Practice address
9972 66TH Rd
Apt 5E
Rego Park, NY 11374-4460
Phone
(646) 500-4255
NPI assigned
Jun 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2966331 NY Primary

Addresses

Primary practice location

9972 66TH Rd
Apt 5E
Rego Park, NY 11374-4460

Mailing address

9972 66TH Rd
Apt 5E
Rego Park, NY 11374-4460
Phone (646) 500-4255

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
2966331NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1433635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433635200000",
    "number": "1528448362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9972 66TH RD",
            "address_2": "APT 5E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744460",
            "telephone_number": "646-500-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9972 66TH RD",
            "address_2": "APT 5E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744460",
            "telephone_number": "646-500-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMNUAN",
        "first_name": "CHAMNONG",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-07",
        "last_updated": "2015-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2966331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2015; 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.