Individual provider Active NPI

Catherine Marie Nicholas, LPN

  • Licensed Practical Nurse
  • Coram, NY
National Provider Identifier
1952536252
Registry record updated May 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
155901-1 Issued in NY
Practice address
23 Shenandoah Blvd
Coram, NY 11727-1729
Phone
(631) 828-6116
NPI assigned
May 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2009

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 155901-1 NY Primary

Addresses

Primary practice location

23 Shenandoah Blvd
Coram, NY 11727-1729

Mailing address

23 Shenandoah Blvd
Coram, NY 11727-1729
Phone (631) 828-6116

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
155901-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1242432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242432000000",
    "number": "1952536252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SHENANDOAH BLVD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271729",
            "telephone_number": "631-828-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SHENANDOAH BLVD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271729",
            "telephone_number": "631-828-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "CATHERINE",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-16",
        "last_updated": "2009-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "155901-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2009; 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.