Individual provider Active NPI

Karlene Mennella

  • Licensed Practical Nurse
  • Shirley, NY
National Provider Identifier
1932457058
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
290201 Issued in NY
Practice address
12 Rockledge Dr
Shirley, NY 11967-2638
Phone
(631) 599-9861
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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 290201 NY Primary

Addresses

Primary practice location

12 Rockledge Dr
Shirley, NY 11967-2638

Mailing address

12 Rockledge Dr
Shirley, NY 11967
Phone (631) 599-9861

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

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1932457058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ROCKLEDGE DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "11967",
            "telephone_number": "631-599-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ROCKLEDGE DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672638",
            "telephone_number": "631-599-9861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNELLA",
        "first_name": "KARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "290201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.