Individual provider Active NPI

Sofia Mykut

  • College Health Registered Nurse
  • University Park, PA
National Provider Identifier
1629778428
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
College Health Registered NurseTaxonomy code 163WC1400X
License
RN768767 Issued in PA
Practice address
180 Bigler Road
University Park, PA 16802
Phone
(814) 863-0774
NPI assigned
Mar 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
College Health Registered Nurse 163WC1400X RN768767 PA Primary

Addresses

Primary practice location

180 Bigler Road
University Park, PA 16802

Mailing address

501 Student Health Ctr
University Park, PA 16802-2129

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

LicenseStateTypeSpecialty
RN768767PAMDCollege Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1629778428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 STUDENT HEALTH CTR",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168022129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 BIGLER ROAD",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "16802",
            "telephone_number": "814-863-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYKUT",
        "first_name": "SOFIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, College Health",
            "state": "PA",
            "license": "RN768767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.