Individual provider Active NPI

Anne Bertha Raymond, LPN

  • Licensed Practical Nurse
  • Elmont, NY
National Provider Identifier
1710111802
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
089692-1 Issued in NY
Practice address
507 Kirkby Rd
Elmont, NY 11003-3523
Phone
(516) 437-9350
Fax
(516) 414-3573
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2009

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 089692-1 NY Primary

Addresses

Primary practice location

507 Kirkby Rd
Elmont, NY 11003-3523

Mailing address

124 Patterson Ave
Hempstead, NY 11550-6537
Phone (516) 414-3573

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
089692-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241481600000",
    "number": "1710111802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 PATTERSON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115506537",
            "telephone_number": "516-414-3573",
            "fax_number": "516-414-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 KIRKBY RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033523",
            "telephone_number": "516-437-9350",
            "fax_number": "516-414-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "ANNE",
        "middle_name": "BERTHA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "089692-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.