Individual provider Active NPI

Phylecia Roberts-Dunbar, LPN,COTA

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1912394347
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
267784-1 Issued in NY
Practice address
736 E 228TH St
Bronx, NY 10466-4212
Phone
(347) 920-5460
NPI assigned
Apr 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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 267784-1 NY Primary

Addresses

Primary practice location

736 E 228TH St
Bronx, NY 10466-4212

Mailing address

PO Box 690
Bronx, NY 10475-0690
Phone (347) 920-5460

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
267784-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1912394347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104750690",
            "telephone_number": "347-920-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 E 228TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104664212",
            "telephone_number": "347-920-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS-DUNBAR",
        "first_name": "PHYLECIA",
        "credential": "LPN,COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "267784-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; 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.