Individual provider Active NPI

Visnja Stavrianopoulos

  • Licensed Practical Nurse
  • Middle Village, NY
National Provider Identifier
1679166573
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
281106-01 Issued in NY
Practice address
6810 79TH St Apt 1R
Middle Village, NY 11379-2943
Phone
(914) 356-4797
NPI assigned
Feb 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 281106-01 NY Primary

Addresses

Primary practice location

6810 79TH St Apt 1R
Middle Village, NY 11379-2943

Mailing address

6810 79TH St Apt 1R
Middle Village, NY 11379-2943
Phone (914) 356-4797

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
281106-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1679166573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 79TH ST APT 1R",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792943",
            "telephone_number": "914-356-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 79TH ST APT 1R",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792943",
            "telephone_number": "914-356-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVRIANOPOULOS",
        "first_name": "VISNJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "281106-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.