Individual provider Active NPI

Patulia Phillip

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1528689072
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
28740 Issued in NY
Practice address
3133 Rochambeau Ave Apt 8D
Bronx, NY 10467-3830
Phone
(718) 500-6227
NPI assigned
May 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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 28740 NY Primary

Addresses

Primary practice location

3133 Rochambeau Ave Apt 8D
Bronx, NY 10467-3830

Mailing address

3133 Rochambeau Ave Apt 8D
Bronx, NY 10467-3830
Phone (718) 500-6227

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Web Direct

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
28740NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1528689072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 ROCHAMBEAU AVE APT 8D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104673830",
            "telephone_number": "718-500-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 ROCHAMBEAU AVE APT 8D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104673830",
            "telephone_number": "718-500-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIP",
        "first_name": "PATULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "28740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Web",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3133 Rochambeau Ave Apt 8D",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104673830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.