Active NPI
Jiayu Li, RN
- Athletic Trainer
- Flushing, NY
National Provider Identifier
1083278774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 762525
- Practice address
- 15043 18TH Ave FL 1
Flushing, NY 11357-3124 - Phone
- (646) 732-3174
- NPI assigned
- Apr 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 762525 | NY | Primary |
Addresses
Primary practice location
15043 18TH Ave FL 1
Flushing, NY 11357-3124
Mailing address
15043 18TH Ave FL 1
Flushing, NY 11357-3124
Phone (646) 732-3174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 689387478 | Other | NY | DMV |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 762525 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556409600000",
"number": "1083278774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15043 18TH AVE FL 1",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113573124",
"telephone_number": "646-732-3174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15043 18TH AVE FL 1",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113573124",
"telephone_number": "646-732-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "JIAYU",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-28",
"last_updated": "2019-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "762525",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMV",
"identifier": "689387478",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.