Individual provider Active NPI

Mitchelle Samedy, LPN

  • Registered Nurse
  • Garnerville, NY
National Provider Identifier
1891034104
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
815023 Issued in NY
Practice address
7 Sand St
Apt 1 a
Garnerville, NY 10923-1434
Phone
(845) 290-7588
NPI assigned
Feb 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 815023 NY Primary
Licensed Practical Nurse 164W00000X 312606 NY

Addresses

Primary practice location

7 Sand St
Apt 1 a
Garnerville, NY 10923-1434

Mailing address

7 Sand St
Apt 1 a
Garnerville, NY 10923-1434
Phone (845) 290-7588

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
815023NYMDRegistered Nurse
312606NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1891034104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SAND ST",
            "address_2": "APT 1 A",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231434",
            "telephone_number": "845-290-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SAND ST",
            "address_2": "APT 1 A",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231434",
            "telephone_number": "845-290-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMEDY",
        "first_name": "MITCHELLE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "815023",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "312606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnerville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.