Mary Ellen Davis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

108497-1 Issued in NY

Practice address

22 Harford Dr
Coram, NY 11727-2909

Phone

(631) 732-1021

Fax

(631) 736-5016

NPI assigned

Mar 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Ellen Campbell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972637262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HARFORD DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272909",
            "telephone_number": "631-732-1021",
            "fax_number": "631-736-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HARFORD DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272909",
            "telephone_number": "631-732-1021",
            "fax_number": "631-736-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARY ELLEN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "108497-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02731708",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ELLEN",
            "last_name": "CAMPBELL",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephen James Czachor
• Dawn Marie D'Amico, R.N.
• Randi E Daponte, RN IBCLC
• Jasmine Charri Daves, L.P.N
• Jenee Davis
• Danielle Marie Decaro, LPN
• Aleya Jasmine Decoursey, RN
• Kari Delemarre Brand, DPT
• Dona Dellarocco-Swaine
• Cristina Delmonico, RN

• Licensed Practical Nurse in Coram, NY
• Providers in Coram, 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 Jul 9, 2007; 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.