Individual provider Active NPI

Yewande Olukemi Peters, RN

  • Registered Nurse
  • Medford, NY
National Provider Identifier
1740560960
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
547367-1 Issued in NY
Practice address
116 Cedar LN
Medford
Medford, NY 11763-1172
Phone
(516) 557-5483
NPI assigned
Aug 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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 547367-1 NY Primary

Addresses

Primary practice location

116 Cedar LN
Medford
Medford, NY 11763-1172

Mailing address

116 Cedar LN
Medford
Medford, NY 11763-1172
Phone (516) 557-5483

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
547367-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1740560960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CEDAR LN",
            "address_2": "MEDFORD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631172",
            "telephone_number": "516-557-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CEDAR LN",
            "address_2": "MEDFORD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631172",
            "telephone_number": "516-557-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "YEWANDE",
        "middle_name": "OLUKEMI",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "547367-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.