Individual provider Active NPI

Angela Rosalie Heron

  • Licensed Practical Nurse
  • Springfield Gardens, NY
National Provider Identifier
1700062858
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
185505 Issued in NY
Practice address
14410 229TH St
Springfield Gardens, NY 11413-3616
Phone
(718) 341-3519
NPI assigned
Jan 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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 185505 NY Primary

Addresses

Primary practice location

14410 229TH St
Springfield Gardens, NY 11413-3616

Mailing address

14410 229TH St
Springfield Gardens, NY 11413-3616
Phone (718) 341-3519

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
185505NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1700062858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14410 229TH ST",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114133616",
            "telephone_number": "718-341-3519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14410 229TH ST",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114133616",
            "telephone_number": "718-341-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERON",
        "first_name": "ANGELA",
        "middle_name": "ROSALIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "185505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.