Individual provider Active NPI

Robert Van Morrison II, N.P.

  • Adult Health Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1790178333
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306282 Issued in NY
Practice address
40 East Ave
Valley Stream, NY 11580-3910
Phone
(917) 519-2468
NPI assigned
Mar 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 600937 NY
Adult Health Nurse Practitioner 363LA2200X 306282 NY Primary

Addresses

Primary practice location

40 East Ave
Valley Stream, NY 11580-3910

Mailing address

40 East Ave
Valley Stream, NY 11580-3910
Phone (917) 519-2468

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
600937NYMDRegistered Nurse
306282NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1790178333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 EAST AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115803910",
            "telephone_number": "917-519-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EAST AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115803910",
            "telephone_number": "917-519-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "ROBERT",
        "middle_name": "VAN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-06",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "600937",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.