Active NPI
Kelly Lynn Casanova, LPN
- Skilled Nursing Facility
- Mastic, NY
National Provider Identifier
1669818100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 245173-1
- Practice address
- 3 Ocean Ave
Mastic, NY 11950-4303 - Phone
- (631) 399-0322
- NPI assigned
- May 10, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 245173-1 | NY | Primary |
Addresses
Primary practice location
3 Ocean Ave
Mastic, NY 11950-4303
Mailing address
3 Ocean Ave
Mastic, NY 11950-4303
Phone (631) 399-0322
Other names 1
- Miss Kelly Lynn Webb
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
| License | State | Type | Specialty |
|---|---|---|---|
| 245173-1 | NY | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368144000000",
"number": "1669818100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 OCEAN AVE",
"city": "MASTIC",
"state": "NY",
"postal_code": "119504303",
"telephone_number": "631-399-0322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 OCEAN AVE",
"city": "MASTIC",
"state": "NY",
"postal_code": "119504303",
"telephone_number": "631-399-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASANOVA",
"first_name": "KELLY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-10",
"last_updated": "2013-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "245173-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "WEBB",
"middle_name": "LYNN",
"prefix": "MISS",
"credential": "LPN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mastic, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.