Individual provider Active NPI

Carmelle Terry Alexis, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1023200599
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2586233 Issued in NY
Practice address
3513 Avenue L
Brooklyn, NY 11210-5443
Phone
(646) 306-0157
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2586233 NY Primary

Addresses

Primary practice location

3513 Avenue L
Brooklyn, NY 11210-5443

Mailing address

3513 Avenue L
Brooklyn, NY 11210-5443
Phone (646) 306-0157

Other identifiers 1

IdentifierTypeStateIssuer
02630495MedicaidNY

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

LicenseStateTypeSpecialty
2586233NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1023200599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105443",
            "telephone_number": "646-306-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3513 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105443",
            "telephone_number": "646-306-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXIS",
        "first_name": "CARMELLE",
        "middle_name": "TERRY",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2586233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02630495",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.