Individual provider Active NPI

Shivani Shivmangal

  • Registered Nurse
  • Merrick, NY
National Provider Identifier
1689096398
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
678716 Issued in NY
Practice address
1698 Reid Ave
Merrick, NY 11566-3043
Phone
(631) 662-1369
NPI assigned
Jan 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 678716 NY Primary

Addresses

Primary practice location

1698 Reid Ave
Merrick, NY 11566-3043

Mailing address

1698 Reid Ave
Merrik, NY 34613
Phone (631) 662-1369

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
678716NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1689096398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 REID AVE",
            "city": "MERRIK",
            "state": "NY",
            "postal_code": "34613",
            "telephone_number": "631-662-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 REID AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663043",
            "telephone_number": "631-662-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVMANGAL",
        "first_name": "SHIVANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "678716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.