Individual provider Active NPI

Patricia McEnroe Damato, RN

  • Registered Nurse
  • Port Saint Lucie, FL
National Provider Identifier
1710173380
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
360404-1 Issued in NY
Practice address
484 SW Columbus Dr
Port Saint Lucie, FL 34953-6042
Phone
(772) 873-3770
Fax
(772) 344-8690
NPI assigned
Sep 18, 2007
Last updated
Sep 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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 360404-1 NY Primary

Addresses

Primary practice location

484 SW Columbus Dr
Port Saint Lucie, FL 34953-6042

Mailing address

484 SW Columbus Dr
Port Saint Lucie, FL 34953-6042
Phone (772) 873-3770

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

LicenseStateTypeSpecialty
360404-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1710173380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 SW COLUMBUS DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536042",
            "telephone_number": "772-873-3770",
            "fax_number": "772-344-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 SW COLUMBUS DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536042",
            "telephone_number": "772-873-3770",
            "fax_number": "772-344-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMATO",
        "first_name": "PATRICIA",
        "middle_name": "MCENROE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "360404-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.