Individual provider Active NPI

Jennifer Kanin

  • Licensed Practical Nurse
  • Corona, NY
National Provider Identifier
1083008957
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
320831 Issued in NY
Practice address
9608 57TH Ave
Apt12C
Corona, NY 11368-3401
Phone
(347) 261-3935
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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 320831 NY Primary

Addresses

Primary practice location

9608 57TH Ave
Apt12C
Corona, NY 11368-3401

Mailing address

96- 08 57TH Ave
Apt12C
Corona, NY 11368
Phone (347) 261-3935

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1083008957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96- 08 57TH AVE",
            "address_2": "APT12C",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "347-261-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9608 57TH AVE",
            "address_2": "APT12C",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683401",
            "telephone_number": "347-261-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANIN",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "320831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.

Verify at the official NPI Registry.