Individual provider Active NPI

Jammy Lay, BSN,RN

  • Emergency Registered Nurse
  • Glendora, CA
National Provider Identifier
1053167882
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
95272521 Issued in CA
Practice address
250 S Grand Ave
Glendora, CA 91741-4218
Phone
(626) 857-3180
NPI assigned
Apr 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 95272521 CA Primary

Addresses

Primary practice location

250 S Grand Ave
Glendora, CA 91741-4218

Mailing address

250 S Grand Ave
Glendora, CA 91741-4218

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95272521CAMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1053167882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414218",
            "telephone_number": "626-857-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "JAMMY",
        "credential": "BSN,RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "95272521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.