Individual provider Active NPI

Denette Borman, RN

  • Registered Nurse
  • New York, NY
National Provider Identifier
1962211375
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
205510 Issued in SC
Practice address
632 Broadway PH
New York, NY 10012-2614
Phone
(800) 731-4254
NPI assigned
Jan 1, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
205510SCMDRegistered Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 205510 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

632 Broadway PH
New York, NY 10012-2614

Mailing address

632 Broadway PH
New York, NY 10012-2614
Phone (800) 731-4254

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 1, 2025.

{
    "created_epoch": "1735689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1962211375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORMAN",
        "first_name": "DENETTE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-01",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "205510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.