Vincent Lamarr Powell Jr., FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95003522 Issued in CA

Practice address

2275 F St Ste 1&2
Livingston, CA 95334-1778

Phone

(209) 394-8854

Fax

(209) 394-8895

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Vincent Lamarr Powell Jr. Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1063633758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210",
            "city": "RIPON",
            "state": "CA",
            "postal_code": "953660210",
            "telephone_number": "209-599-4211",
            "fax_number": "209-599-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 F ST STE 1&2",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953341778",
            "telephone_number": "209-394-8854",
            "fax_number": "209-394-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "VINCENT",
        "middle_name": "LAMARR",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OH",
            "license": "RN281973",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95003522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP",
            "identifier": "95003492",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VINCENT",
            "last_name": "POWELL",
            "middle_name": "LAMARR",
            "suffix": "JR.",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rosa Maria Pavey, LVN
• William Charles Pearson Jr., CADC II/ICADC
• Junabel Mariano Pedro
• Monica Guadalupe Perez
• Connie Phan, B.S.
• Ivan M Prado
• Augie N. Provencio
• Jade Rose Puckett
• Afnan Aisha Qadeer, M.D.
• Maria D Ramirez, EMT

• Nurse Practitioner in Livingston, CA
• Providers in Livingston, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.