Individual provider Active NPI

Rachel Calire

  • Registered Nurse
  • Lake Grove, NY
National Provider Identifier
1104397207
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
760117 Issued in NY
Practice address
12 Frederick Ave
Lake Grove, NY 11755-3212
Phone
(631) 566-5706
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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 760117 NY Primary

Addresses

Primary practice location

12 Frederick Ave
Lake Grove, NY 11755-3212

Mailing address

12 Frederick Ave
Lake Grove, NY 11755-3212

Other identifiers 1

IdentifierTypeStateIssuer
760117OtherNYREGISTERED PROFESSIONAL NURSING LICENSE

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
760117NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1104397207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FREDERICK AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117553212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 FREDERICK AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117553212",
            "telephone_number": "631-566-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIRE",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "760117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED PROFESSIONAL NURSING LICENSE",
            "identifier": "760117",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.