Individual provider Active NPI

Mindi Derry

  • Nursing Care Agency
  • Long Beach, NY
National Provider Identifier
1538625793
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Practice address
53 Pennsylvania Ave
Long Beach, NY 11561-1621
Phone
(929) 888-4791
NPI assigned
Feb 13, 2019
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU Primary

Addresses

Primary practice location

53 Pennsylvania Ave
Long Beach, NY 11561-1621

Mailing address

53 Pennsylvania Ave
Long Beach, NY 11561-1621
Phone (929) 888-4791

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

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1538625793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PENNSYLVANIA AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611621",
            "telephone_number": "929-888-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 PENNSYLVANIA AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611621",
            "telephone_number": "929-888-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRY",
        "first_name": "MINDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.