Active NPI
Edwine Champagne
- Registered Nurse
- Rosedale, NY
National Provider Identifier
1558787366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 669110-1
- Practice address
- 24562 148TH Dr
Rosedale, NY 11422-2708 - Phone
- (516) 587-1889
- NPI assigned
- Mar 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 669110-1 | NY | Primary |
Addresses
Primary practice location
24562 148TH Dr
Rosedale, NY 11422-2708
Mailing address
24562 148TH Dr
Rosedale, NY 11422-2708
Phone (516) 587-1889
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
| License | State | Type | Specialty |
|---|---|---|---|
| 669110-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395014400000",
"number": "1558787366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24562 148TH DR",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114222708",
"telephone_number": "516-587-1889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24562 148TH DR",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114222708",
"telephone_number": "516-587-1889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNE",
"first_name": "EDWINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-17",
"last_updated": "2014-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "669110-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.