Individual provider Active NPI

Sheryl Nodeland, RN

  • Registered Nurse
  • Port Jeff Sta, NY
National Provider Identifier
1770800583
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
401798 Issued in NY
Practice address
17 Oxford Dr
Port Jeff Sta, NY 11776-2051
Phone
(631) 331-4702
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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 401798 NY Primary

Addresses

Primary practice location

17 Oxford Dr
Port Jeff Sta, NY 11776-2051

Mailing address

17 Oxford Dr
Port Jeff Sta, NY 11776-2051
Phone (631) 331-4702

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
401798NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272844800000",
    "number": "1770800583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 OXFORD DR",
            "city": "PORT JEFF STA",
            "state": "NY",
            "postal_code": "117762051",
            "telephone_number": "631-331-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 OXFORD DR",
            "city": "PORT JEFF STA",
            "state": "NY",
            "postal_code": "117762051",
            "telephone_number": "631-331-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODELAND",
        "first_name": "SHERYL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "401798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jeff Sta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.