Individual provider Active NPI

Dieufanie St Jean Alexis

  • Licensed Practical Nurse
  • Spring Valley, NY
National Provider Identifier
1083081012
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
3165331 Issued in NY
Practice address
40 S Cole Ave Apt 1J
Spring Valley, NY 10977-5423
Phone
(845) 641-6680
NPI assigned
Aug 25, 2015
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 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 3165331 NY Primary

Addresses

Primary practice location

40 S Cole Ave Apt 1J
Spring Valley, NY 10977-5423

Mailing address

40 S Cole Ave Apt 1J
Spring Valley, NY 10977-5423
Phone (845) 641-6680

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
3165331NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1083081012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 S COLE AVE APT 1J",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775423",
            "telephone_number": "845-641-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S COLE AVE APT 1J",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775423",
            "telephone_number": "845-641-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXIS",
        "first_name": "DIEUFANIE",
        "middle_name": "ST JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "3165331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.