Active NPI
Kathleen Suzanne Roche
- Registered Nurse
- Huntington, NY
National Provider Identifier
1821796038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 310725
- Practice address
- 36 Brand Dr
Huntington, NY 11743-4503 - Phone
- (631) 549-0864
- NPI assigned
- Feb 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 310725 | NY | Primary |
Addresses
Primary practice location
36 Brand Dr
Huntington, NY 11743-4503
Mailing address
36 Brand Dr
Huntington, NY 11743-4503
Phone (631) 549-0864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 310725 | Other | NY | PROFESSIONAL REGISTERED NURSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 310725 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1821796038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 BRAND DR",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434503",
"telephone_number": "631-549-0864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 BRAND DR",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434503",
"telephone_number": "631-549-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCHE",
"first_name": "KATHLEEN",
"middle_name": "SUZANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-16",
"last_updated": "2023-02-16",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "310725",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL REGISTERED NURSE",
"identifier": "310725",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.