Coach Vera's Slow & Steady Health Program

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COACH VERA'S SLOW & STEADY HEALTH PROGRAM

Practice address

80 Union Ave
Staten Island, NY 10303-2426

Phone

(718) 813-5945

NPI assigned

Feb 16, 2022

Last updated

Jul 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Vera Gill, RNNPI 1437524568

Title

CDC NDPP Lifestyle Coach

Phone

(718) 813-5945

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vera Gill

  • Registered Nurse
  • Staten Island, NY
  • NPI 1437524568
  NPD Authorized official
• Denise Beachem

  • Health & Wellness Coach
  • Staten Island, NY
  • NPI 1881320455
  NPD

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1629723804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 MAPLE PKWY # 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032464",
            "telephone_number": "718-813-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 UNION AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032426",
            "telephone_number": "718-813-5945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 Maple Pkwy # 2",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103032464",
            "country_code": "US",
            "telephone_number": "718-813-5945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COACH VERA'S SLOW & STEADY HEALTH PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "CDC NDPP LIFESTYLE COACH",
        "authorized_official_telephone_number": "718-813-5945",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649819889",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881320455",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982030698",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437524568",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.