Individual provider Active NPI

Doreen Lynn Degran, RN

  • Registered Nurse
  • Rochester, NY
National Provider Identifier
1104152420
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
504956-1 Issued in NY
Practice address
143 Woodstone Lane
Rochester, NY 14626
Phone
(585) 576-4873
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 504956-1 NY Primary

Addresses

Primary practice location

143 Woodstone Lane
Rochester, NY 14626

Mailing address

143 Woodstone Lane
Rochester, NY 14626
Phone (585) 576-4873

Other names 1

  • Doreen Lynn Jones Former name

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

LicenseStateTypeSpecialty
504956-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1104152420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 WOODSTONE LANE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14626",
            "telephone_number": "585-576-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 WOODSTONE LANE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14626",
            "telephone_number": "585-576-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAN",
        "first_name": "DOREEN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "504956-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOREEN",
            "last_name": "JONES",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.