Active NPI
Shervone Theophilus, RN
- Home Health Registered Nurse
- Brooklyn, NY
National Provider Identifier
1700216751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 671217
- Practice address
- 85 Bartlett St
Brooklyn, NY 11206-4429 - Phone
- (718) 782-1538
- NPI assigned
- Nov 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 671217 | NY | Primary |
Addresses
Primary practice location
85 Bartlett St
Brooklyn, NY 11206-4429
Mailing address
33 Roosevelt Dr Apt 319
Derby, CT 06418-1670
Phone (321) 439-8426
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 671217 | NY | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384214400000",
"number": "1700216751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 ROOSEVELT DR APT 319",
"city": "DERBY",
"state": "CT",
"postal_code": "064181670",
"telephone_number": "321-439-8426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 BARTLETT ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112064429",
"telephone_number": "718-782-1538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEOPHILUS",
"first_name": "SHERVONE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-12",
"last_updated": "2013-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "NY",
"license": "671217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.