CORRINE JURGENS (NPI# 1720294077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720294077 |
| Entity Type | Individual |
| Full Name | CORRINE JURGENS |
| Practice Address |
75 N Country Rd Port Jefferson NY 11777-2119 |
| Mailing Address |
625 Belle Terre Rd Suite 100 Port Jefferson NY 11777-2316 |
| Practice Telephone | 6314731320 |
| Practice Fax Number | 6313312766 |
| Mailing Telephone | 6314731320 |
| Mailing Fax Number | 6313312766 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 096500 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
75 N COUNTRY RD |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718728 | John T. Mather Memorial Hospital | Psychiatric Unit | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2005-05-27 |
| 1124633169 | Ewelina Mieczkowska | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-09-15 |
| 1114546652 | Kelly Miller | Registered Nurse | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-14 |
| 1194344143 | John Lotfi | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-10 |
| 1669001897 | Robert Franklin Wilson | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-08 |
| 1245868611 | Tia Bimal | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-31 |
| 1427686203 | Aakash Babaria | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-29 |
| 1821626789 | Anjali Kewalramani | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
| 1578190591 | Joon Oh | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2190 | 2020-03-27 |
| 1871121848 | Sonali Nanda | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1083047674 | Hurline L Jeudy | Nurse Practitioner | 200 Belle Terre Rd, Suite 110, Port Jefferson, NY 11777-1928 | 2013-08-19 |
| 1033358841 | Joanne F Angstadt | Nurse Practitioner | 200 Belle Terre Road, Port Jefferson, NY 11733 | 2009-02-18 |
| 1427223460 | Kristen Jeanne Vetrano | Nurse Practitioner | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2008-04-29 |
| 1972726024 | Patricia A Hebron | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2007-04-10 |
| 1649327065 | Carol Elizabeth Bonura | Nurse Practitioner | 118 North Country Road, Port Jefferson, NY 11777 | 2007-01-05 |
| 1487711636 | Susan Phelan | Nurse Practitioner | 640 Belle Terre Rd, Suite J2-3, Port Jefferson, NY 11777-1936 | 2007-01-03 |
| 1700941382 | Kim Decastro | Nurse Practitioner | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2006-12-26 |
| 1396803540 | Angela V Guerrazzi | Nurse Practitioner | 1000 Main St, Suite 1, Port Jefferson, NY 11777-2250 | 2006-12-04 |
| 1053492017 | Genine Schwinge | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2006-10-18 |
| Find all providers in PORT JEFFERSON | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.