Individual provider Active NPI

Niko Konan, LPN

  • Licensed Practical Nurse
  • Wappingers Falls, NY
National Provider Identifier
1790208148
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
328280 Issued in NY
Practice address
4 Marshall Rd Ste 248
Wappingers Falls, NY 12590-4105
Phone
(845) 309-3435
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 328280 NY Primary

Addresses

Primary practice location

4 Marshall Rd Ste 248
Wappingers Falls, NY 12590-4105

Mailing address

PO Box 1588
Wappingers Falls, NY 12590-8588
Phone (845) 309-3435

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
328280NYMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1790208148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1588",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125908588",
            "telephone_number": "845-309-3435",
            "fax_number": "845-231-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MARSHALL RD STE 248",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125904105",
            "telephone_number": "845-309-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONAN",
        "first_name": "NIKO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "328280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wappingers Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.