Individual provider Active NPI

Anatoliy Vernikov

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1932674686
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
302471-1 Issued in NY
Practice address
1463 Ocean Ave
Brooklyn, NY 11230-3978
Phone
(917) 624-4040
NPI assigned
Oct 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 302471-1 NY Primary

Addresses

Primary practice location

1463 Ocean Ave
Brooklyn, NY 11230-3978

Mailing address

1463 Ocean Ave
Brooklyn, NY 11230-3978
Phone (917) 624-4040

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
302471-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1932674686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303978",
            "telephone_number": "917-624-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303978",
            "telephone_number": "917-624-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNIKOV",
        "first_name": "ANATOLIY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "302471-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.