Opal Buchanan

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2702051 Issued in NY

Practice address

210 Hillside Ave
Mount Vernon, NY 10553-1808

Phone

(914) 439-9340

NPI assigned

Jun 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Opal Buchanan Gray Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1659785939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HILLSIDE AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HILLSIDE AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531808",
            "telephone_number": "914-439-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "OPAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2702051",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "30009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OPAL",
            "last_name": "BUCHANAN GRAY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vivienne P Brown, LPN
• Ty Browne, LMSW, CLC
• Jennifer Brusca
• Daisy Bryan
• Leslie Bryant
• Daija Bullard
• Naeema Burgess, PSYD, ABSNP-D, LP
• Nuruddin Burns
• Muriel L Burrell, LPN
• Elspeth Burton

• Licensed Practical Nurse in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.