Individual provider Active NPI

Latoya Collymore

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1730695321
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
309058 Issued in NY
Practice address
3463 Seymour Ave Apt 3B
Bronx, NY 10469-2119
Phone
(347) 722-4485
NPI assigned
Dec 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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 309058 NY Primary

Addresses

Primary practice location

3463 Seymour Ave Apt 3B
Bronx, NY 10469-2119

Mailing address

3463 Seymour Ave Apt 3B
Bronx, NY 10469-2119
Phone (347) 722-4485

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
309058NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1730695321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3463 SEYMOUR AVE APT 3B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692119",
            "telephone_number": "347-722-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3463 SEYMOUR AVE APT 3B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692119",
            "telephone_number": "347-722-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLYMORE",
        "first_name": "LATOYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "309058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.