Individual provider Active NPI

Tara Newcomb

  • School Registered Nurse
  • Centereach, NY
National Provider Identifier
1679824205
Registry record updated Sep 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
645787 Issued in NY
Practice address
11 Clarkson Rd
Centereach, NY 11720-2303
Phone
(631) 648-8343
NPI assigned
Sep 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 645787 NY Primary

Addresses

Primary practice location

11 Clarkson Rd
Centereach, NY 11720-2303

Mailing address

11 Clarkson Rd
Centereach, NY 11720-2303
Phone (631) 648-8343

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
645787NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1348272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348272000000",
    "number": "1679824205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CLARKSON RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202303",
            "telephone_number": "631-648-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CLARKSON RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202303",
            "telephone_number": "631-648-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-22",
        "last_updated": "2012-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "645787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2012; 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.