Individual provider Active NPI

Kelly Ann Marsicano, LPN

  • Licensed Practical Nurse
  • Shirley, NY
National Provider Identifier
1598141376
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
322622 Issued in NY
Practice address
35 Arrowhead Dr
Shirley, NY 11967-2618
Phone
(352) 278-5561
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 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 322622 NY Primary

Addresses

Primary practice location

35 Arrowhead Dr
Shirley, NY 11967-2618

Mailing address

35 Arrowhead Dr
Shirley, NY 11967-2618
Phone (352) 278-5561

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1598141376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ARROWHEAD DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672618",
            "telephone_number": "352-278-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 ARROWHEAD DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672618",
            "telephone_number": "352-278-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSICANO",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "322622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.