Individual provider Active NPI

Marcia Brady Loughran, FNP

  • Family Nurse Practitioner
  • Shrub Oak, NY
National Provider Identifier
1790843548
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F332129-1 Issued in NY
Practice address
31-51 Stoney St.
Pheonix House
Shrub Oak, NY 10058
Phone
(914) 962-2491
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F332129-1 NY Primary

Addresses

Primary practice location

31-51 Stoney St.
Pheonix House
Shrub Oak, NY 10058

Mailing address

2168 19TH St
Apt 1
Astoria, NY 11105-3933
Phone (718) 267-7174

Other identifiers 1

IdentifierTypeStateIssuer
00371673MedicaidNY

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
F332129-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790843548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2168 19TH ST",
            "address_2": "APT 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111053933",
            "telephone_number": "718-267-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31-51 STONEY ST.",
            "address_2": "PHEONIX HOUSE",
            "city": "SHRUB OAK",
            "state": "NY",
            "postal_code": "10058",
            "telephone_number": "914-962-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHRAN",
        "first_name": "MARCIA",
        "middle_name": "BRADY",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332129-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00371673",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrub Oak, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.