Individual provider Active NPI

Tina Michelle Norman, LPN

  • Licensed Practical Nurse
  • Staatsburg, NY
National Provider Identifier
1811298086
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
279835-1 Issued in NY
Practice address
1824 Route 9G
Lot F8
Staatsburg, NY 12580-6180
Phone
(845) 264-7170
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 279835-1 NY Primary

Addresses

Primary practice location

1824 Route 9G
Lot F8
Staatsburg, NY 12580-6180

Mailing address

1824 Route 9G
Lot F8
Staatsburg, NY 12580-6180
Phone (845) 264-7170

Other identifiers 1

IdentifierTypeStateIssuer
279835-1OtherNYLPN LICENSE

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
279835-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1811298086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 ROUTE 9G",
            "address_2": "LOT F8",
            "city": "STAATSBURG",
            "state": "NY",
            "postal_code": "125806180",
            "telephone_number": "845-264-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 ROUTE 9G",
            "address_2": "LOT F8",
            "city": "STAATSBURG",
            "state": "NY",
            "postal_code": "125806180",
            "telephone_number": "845-264-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "TINA",
        "middle_name": "MICHELLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "279835-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN LICENSE",
            "identifier": "279835-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staatsburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.