Individual provider Active NPI

Julia Marie Andenmatten, LPN

  • Licensed Practical Nurse
  • Smithtown, NY
National Provider Identifier
1740567833
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
297217-1 Issued in NY
Practice address
2 Johns Street
Smithtown, NY 11787-1626
Phone
(631) 987-5322
NPI assigned
Nov 3, 2011
Last updated
Nov 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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 297217-1 NY Primary

Addresses

Primary practice location

2 Johns Street
Smithtown, NY 11787-1626

Mailing address

2 John Street
Smithtown, NY 11787-1626
Phone (631) 987-5322

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
297217-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1740567833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JOHN STREET",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871626",
            "telephone_number": "631-987-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JOHNS STREET",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871626",
            "telephone_number": "631-987-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDENMATTEN",
        "first_name": "JULIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "297217-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.