Individual provider Active NPI

Naurda Cameron

  • Licensed Practical Nurse
  • Mount Vernon, NY
National Provider Identifier
1861684128
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
288888-1 Issued in NY
Practice address
530 S 5TH Ave
Mount Vernon, NY 10550-4408
Phone
(914) 699-8569
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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 288888-1 NY Primary

Addresses

Primary practice location

530 S 5TH Ave
Mount Vernon, NY 10550-4408

Mailing address

530 S 5TH Ave
Mount Vernon, NY 10550-4408
Phone (914) 699-8569

Other identifiers 1

IdentifierTypeStateIssuer
02888640MedicaidNY

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
288888-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1861684128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S 5TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504408",
            "telephone_number": "914-699-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S 5TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504408",
            "telephone_number": "914-699-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "NAURDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "288888-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02888640",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.