NPIMap

Organization Active NPI

Icarern

  • General Practice Physician
  • Coram, NY
National Provider Identifier
1841992492
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ICARERN
Practice address
202 W Yaphank Rd
Coram, NY 11727-4073
Phone
(631) 933-8897
NPI assigned
Mar 20, 2023
Last updated
Mar 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Miss Natasha JacksonNPI 1336520030
Title
Cno
Phone
(631) 933-8897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

202 W Yaphank Rd
Coram, NY 11727-4073

Mailing address

202 W Yaphank Rd
Coram, NY 11727-4073
Phone (631) 933-8897

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1841992492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W YAPHANK RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274073",
            "telephone_number": "631-933-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W YAPHANK RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274073",
            "telephone_number": "631-933-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-19",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CNO",
        "authorized_official_telephone_number": "631-933-8897",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.

Verify at the official NPI Registry.