Individual provider Active NPI

Rebecca Jean Caesar

  • Licensed Practical Nurse
  • Endicott, NY
National Provider Identifier
1104105295
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
304329-1 Issued in NY
Practice address
5 1/2 Arthur Ave
Endicott, NY 13760-5505
Phone
(607) 341-6311
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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 304329-1 NY Primary

Addresses

Primary practice location

5 1/2 Arthur Ave
Endicott, NY 13760-5505

Mailing address

5 1/2 Arthur Ave
Endicott, NY 13760-5505
Phone (607) 341-6311

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
304329-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1104105295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 1/2 ARTHUR AVE",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605505",
            "telephone_number": "607-341-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 1/2 ARTHUR AVE",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605505",
            "telephone_number": "607-341-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAESAR",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "304329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.