Individual provider Active NPI

Novelette Pennant, LPN

  • Licensed Practical Nurse
  • Freeport, NY
National Provider Identifier
1063736387
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
262167 Issued in NY
Practice address
139 Lakeview Ave
Freeport, NY 11520-2515
Phone
(516) 974-5692
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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 262167 NY Primary

Addresses

Primary practice location

139 Lakeview Ave
Freeport, NY 11520-2515

Mailing address

139 Lakeview Ave
Freeport, NY 11520-2515
Phone (516) 974-5692

Other names 1

  • Novelette Downey Other name

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": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1063736387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 LAKEVIEW AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202515",
            "telephone_number": "516-974-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 LAKEVIEW AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202515",
            "telephone_number": "516-974-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNANT",
        "first_name": "NOVELETTE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "262167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOVELETTE",
            "last_name": "DOWNEY",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.