Individual provider Active NPI

Cymanda Monique Dugan, LPN

  • Licensed Practical Nurse
  • South Fallsburg, NY
National Provider Identifier
1720335714
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
299459 Issued in NY
Practice address
5264 Main St
Box 842
South Fallsburg, NY 12779
Phone
(845) 434-4573
NPI assigned
Aug 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 299459 NY Primary

Addresses

Primary practice location

5264 Main St
Box 842
South Fallsburg, NY 12779

Mailing address

PO Box 842
5264 Main St
South Fallsburg, NY 12779
Phone (845) 434-4573

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
299459NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1720335714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842",
            "address_2": "5264 MAIN ST",
            "city": "SOUTH FALLSBURG",
            "state": "NY",
            "postal_code": "12779",
            "telephone_number": "845-434-4573",
            "fax_number": "845-434-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5264 MAIN ST",
            "address_2": "BOX 842",
            "city": "SOUTH FALLSBURG",
            "state": "NY",
            "postal_code": "12779",
            "telephone_number": "845-434-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "CYMANDA",
        "middle_name": "MONIQUE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "299459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Fallsburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.