Individual provider Active NPI

Dominique Sade Brown, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1053933218
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
337397 Issued in NY
Practice address
22 Avis St
Rochester, NY 14615-3408
Phone
(585) 439-9273
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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 337397 NY Primary

Addresses

Primary practice location

22 Avis St
Rochester, NY 14615-3408

Mailing address

22 Avis St
Rochester, NY 14615-3408
Phone (585) 439-9273

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

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1053933218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 AVIS ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146153408",
            "telephone_number": "585-439-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 AVIS ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146153408",
            "telephone_number": "585-439-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DOMINIQUE",
        "middle_name": "SADE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "337397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.