Active NPI
Sonya Sheppard
- Registered Nurse
- Bayside, NY
National Provider Identifier
1982051082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 490790-1
- Practice address
- 29-01 216TH St
St. Marys Community Care Professionals
Bayside, NY 11360 - Phone
- (718) 281-8573
- NPI assigned
- May 18, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 490790-1 | NY | Primary |
Addresses
Primary practice location
29-01 216TH St
St. Marys Community Care Professionals
Bayside, NY 11360
Mailing address
35 Osborne Rd
W Hempstead, NY 11552-1301
Phone (917) 817-6553
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
| License | State | Type | Specialty |
|---|---|---|---|
| 490790-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1982051082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 OSBORNE RD",
"city": "W HEMPSTEAD",
"state": "NY",
"postal_code": "115521301",
"telephone_number": "917-817-6553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29-01 216TH ST",
"address_2": "ST. MARYS COMMUNITY CARE PROFESSIONALS",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11360",
"telephone_number": "718-281-8573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "SONYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-18",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "490790-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.