Individual provider Active NPI

Jennifer Grace Gauthier, LPN

  • Licensed Practical Nurse
  • Buffalo, NY
National Provider Identifier
1073221834
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
337435-01 Issued in NY
Practice address
32 Gallatin Ave
Buffalo, NY 14207-2124
Phone
(716) 465-2080
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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 337435-01 NY Primary

Addresses

Primary practice location

32 Gallatin Ave
Buffalo, NY 14207-2124

Mailing address

32 Gallatin Ave
Buffalo, NY 14207-2124
Phone (716) 465-2080

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
337435-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1073221834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 GALLATIN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142072124",
            "telephone_number": "716-465-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 GALLATIN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142072124",
            "telephone_number": "716-465-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "JENNIFER",
        "middle_name": "GRACE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "337435-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.