Individual provider Active NPI

Nicole Danielle McGinnis

  • Specialist
  • Patchogue, NY
National Provider Identifier
1669850905
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2249960 Issued in NY
Practice address
123 Arlington St
Patchogue, NY 11772-1537
Phone
(631) 603-4385
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2249960 NY Primary

Addresses

Primary practice location

123 Arlington St
Patchogue, NY 11772-1537

Mailing address

123 Arlington St
Patchogue, NY 11772-1537
Phone (631) 603-4385

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
2249960NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1669850905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ARLINGTON ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721537",
            "telephone_number": "631-603-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ARLINGTON ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721537",
            "telephone_number": "631-603-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "NICOLE",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2249960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.