Individual provider Active NPI

Frederick Horn, RN

  • Registered Nurse
  • Medford, NY
National Provider Identifier
1992047708
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
275863-1 Issued in NY
Practice address
1727 N Ocean Ave
Medford, NY 11763-2649
Phone
(631) 654-1919
NPI assigned
Mar 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 275863-1 NY Primary

Addresses

Primary practice location

1727 N Ocean Ave
Medford, NY 11763-2649

Mailing address

2 Wintergreen LN
Westhampton, NY 11977-1431
Phone (631) 654-1919

Other identifiers 1

IdentifierTypeStateIssuer
275863-1OtherNYLICENSE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
275863-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1992047708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WINTERGREEN LN",
            "city": "WESTHAMPTON",
            "state": "NY",
            "postal_code": "119771431",
            "telephone_number": "631-654-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 N OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-654-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "FREDERICK",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "275863-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "275863-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.