Individual provider Active NPI

Elizabeth Ann Stillwell, R.N.

  • Registered Nurse
  • Mineola, NY
National Provider Identifier
1619271202
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
484759 Issued in NY
Practice address
235 Marcellus Rd
Mineola, NY 11501-2415
Phone
(516) 742-3835
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 484759 NY Primary

Addresses

Primary practice location

235 Marcellus Rd
Mineola, NY 11501-2415

Mailing address

235 Marcellus Rd
Mineola, NY 11501-2415
Phone (516) 742-3835

Other identifiers 1

IdentifierTypeStateIssuer
01906069MedicaidNY

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
484759NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1619271202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MARCELLUS RD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012415",
            "telephone_number": "516-742-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MARCELLUS RD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012415",
            "telephone_number": "516-742-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWELL",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "484759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01906069",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.