Individual provider Active NPI

Ann Valerie McKenna

  • Registered Nurse
  • Farmingdale, NY
National Provider Identifier
1740954304
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
485694 Issued in NY
Practice address
35 4TH Ave
Farmingdale, NY 11735-5721
Phone
(516) 382-6520
NPI assigned
Aug 5, 2021
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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 485694 NY Primary

Addresses

Primary practice location

35 4TH Ave
Farmingdale, NY 11735-5721

Mailing address

35 4TH Ave
Farmingdale, NY 11735-5721
Phone (516) 382-6520

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
485694NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1740954304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 4TH AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117355721",
            "telephone_number": "516-382-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 4TH AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117355721",
            "telephone_number": "516-382-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "ANN",
        "middle_name": "VALERIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "485694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.