Individual provider Active NPI

Jessica Christina Reyes

  • Licensed Practical Nurse
  • Rego Park, NY
National Provider Identifier
1093046906
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
299085-1 Issued in NY
Practice address
9715 64TH Rd
Rego Park, NY 11374-2250
Phone
(718) 459-5592
Fax
(718) 459-6047
NPI assigned
Jan 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 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 299085-1 NY Primary

Addresses

Primary practice location

9715 64TH Rd
Rego Park, NY 11374-2250

Mailing address

632 Beach 65TH St
Arverne, NY 11692-1355
Phone (484) 547-1421

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
299085-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1093046906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BEACH 65TH ST",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921355",
            "telephone_number": "484-547-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742250",
            "telephone_number": "718-459-5592",
            "fax_number": "718-459-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JESSICA",
        "middle_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "299085-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.