Active NPI
Kettlene Casimir
- Registered Nurse
- Bronx, NY
National Provider Identifier
1053740167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 698868-1
- Practice address
- 1241 Fulton Ave
2ND Floor
Bronx, NY 10456-3401 - Phone
- (774) 268-0410
- NPI assigned
- Nov 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 698868-1 | NY | Primary |
| Licensed Practical Nurse | 164W00000X | 310891 | NY |
Addresses
Primary practice location
1241 Fulton Ave
2ND Floor
Bronx, NY 10456-3401
Mailing address
1241 Fulton Ave
2ND Floor
Bronx, NY 10456-3401
Phone (774) 268-0410
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
| License | State | Type | Specialty |
|---|---|---|---|
| 698868-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1053740167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 FULTON AVE",
"address_2": "2ND FLOOR",
"city": "BRONX",
"state": "NY",
"postal_code": "104563401",
"telephone_number": "774-268-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 FULTON AVE",
"address_2": "2ND FLOOR",
"city": "BRONX",
"state": "NY",
"postal_code": "104563401",
"telephone_number": "774-268-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASIMIR",
"first_name": "KETTLENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-08",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "698868-1",
"primary": true
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "310891",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.