Renee Jodelle Praddy, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

346030 Issued in NY

Practice address

22002 108TH Ave
Queens Village, NY 11429-2437

Phone

(718) 812-8494

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1033707732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22002 108TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292437",
            "telephone_number": "718-812-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22002 108TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292437",
            "telephone_number": "718-812-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADDY",
        "first_name": "RENEE",
        "middle_name": "JODELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Plummer
• Elisabeth Poincy, LPN
• Sophia A Polynice
• Yu Chun Poon, LCSW
• Anne Marie Post-Regan
• Farah J Pragga, PHARMD
• Mercy Prasad, RN
• Bryan Joseph Prechtl, R.PH.
• Aneta Predanic
• Monica A Prendergast, LCSW

• Family Nurse Practitioner in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.