Althea Marie Burgess, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

204219 Issued in NY

Practice address

158 Maida Ave
Deer Park, NY 11729

Phone

(631) 242-0637

NPI assigned

May 28, 2008

Last updated

May 28, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1942468889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 MAIDA AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "11729",
            "telephone_number": "631-242-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 MAIDA AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "11729",
            "telephone_number": "631-242-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ALTHEA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "204219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02108845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarafina Brewer, COVT
• Anthony D Bridgeman, ED.D
• Amaka Bright-Ihediwa
• Clarissa Lynn Brown, NP
• Geraldine Bruno
• Beverly Burns, MS., ED.M.
• Ryan M. Cahill, D.O.
• Josette M Caivano, COTA
• Natasha Calixte, LMT
• Sophia Calixte

• Licensed Practical Nurse in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.