Individual provider Active NPI

Deborah Brown, LPN

  • Licensed Practical Nurse
  • Chittenango, NY
National Provider Identifier
1053709766
Registry record updated Dec 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
278645-1 Issued in NY
Practice address
5958 Falls Blvd
Chittenango, NY 13037-8798
Phone
(315) 761-7531
NPI assigned
Jan 3, 2015
Last updated
Dec 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2019

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 278645-1 NY Primary

Addresses

Primary practice location

5958 Falls Blvd
Chittenango, NY 13037-8798

Mailing address

5958 Falls Blvd
Chittenango, NY 13037-8798
Phone (315) 761-7531

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
278645-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1420243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577491200000",
    "number": "1053709766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5958 FALLS BLVD",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130378798",
            "telephone_number": "315-761-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 FALLS BLVD",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130378798",
            "telephone_number": "315-761-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-03",
        "last_updated": "2019-12-28",
        "certification_date": "2019-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "278645-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chittenango, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2019; 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.