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  7. NPI Record 1760954754

MRS. KARESA A MCPHOY-PHILIPPEAU DNP, FNP-BC, A-GNP-C
Complete NPI Record 1760954754
Nurse Practitioner - Family in Bronx, NY

NPI Status: Active since January 02, 2019

Contact Information

3380 RESERVOIR OVAL E
BRONX, NY
ZIP 10467
Phone: (516) 474-1132

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider Other Last Name
  9. Provider Other First Name
  10. Provider Other Middle Name
  11. Provider Other Name Prefix Text
  12. Provider Other Credential Text
  13. Provider Other Last Name Type Code
  14. Provider First Line Business Mailing Address
  15. Provider Business Mailing Address City Name
  16. Provider Business Mailing Address State Name
  17. Provider Business Mailing Address Postal Code
  18. Provider Business Mailing Address Country Code If outside U S
  19. Provider Business Mailing Address Telephone Number
  20. Provider First Line Business Practice Location Address
  21. Provider Business Practice Location Address City Name
  22. Provider Business Practice Location Address State Name
  23. Provider Business Practice Location Address Postal Code
  24. Provider Business Practice Location Address Country Code If outside U S
  25. Provider Business Practice Location Address Telephone Number
  26. Provider Enumeration Date
  27. Last Update Date
  28. Provider Gender Code
  29. Healthcare Provider Taxonomy Code 1
  30. Provider License Number 1
  31. Provider License Number State Code 1
  32. Healthcare Provider Primary Taxonomy Switch 1
  33. Healthcare Provider Taxonomy Code 2
  34. Provider License Number 2
  35. Provider License Number State Code 2
  36. Healthcare Provider Primary Taxonomy Switch 2
  37. Is Sole Proprietor
  38. Healthcare Provider Taxonomy Group 1
  39. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1760954754. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1760954754
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: KARESA
The first name of the provider, if the provider is an individual.
Provider Middle Name: A
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MRS.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: DNP, FNP-BC, A-GNP-C
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name: MCPHOY-PHILIPPEAU
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider Other First Name: KARESA
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Other Middle Name: A
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Other Name Prefix Text: MRS.
The first name of the provider, if the provider is an individual.
Provider Other Credential Text: DNP, FNP-BC, A-GNP
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Other Last Name Type Code: 1
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 3380 RESERVOIR OVAL E
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider Business Mailing Address City Name: BRONX
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 104673100
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 1876964126
The State code in the location of the provider being identified.
Provider First Line Business Practice Location Address: 3380 RESERVOIR OVAL E
The State code in the location of the provider being identified.
Provider Business Practice Location Address City Name: BRONX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NY
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 104673100
The State code in the location of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5164741132
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/2/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 3/7/2023
The date that a record was last updated or changed.
Provider Gender Code: F
The date the provider was assigned a unique identifier (assigned an NPI).
Healthcare Provider Taxonomy Code 1: 363LA2200X
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number 1: 308019
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: NY
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 363LF0000X
Provider License Number 2: 343734
The first name of the authorized official.
Provider License Number State Code 2: NY
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 10/22/2021