Individual provider Active NPI

Jessica Frances Aboagye, R.N., B.S.N.

  • Home Health Registered Nurse
  • Sound Beach, NY
National Provider Identifier
1114205754
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
658179 Issued in NY
Practice address
57 Waterville Dr
Sound Beach, NY 11789-2138
Phone
(631) 433-5098
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 658179 NY Primary

Addresses

Primary practice location

57 Waterville Dr
Sound Beach, NY 11789-2138

Mailing address

57 Waterville Dr
Sound Beach, NY 11789-2138
Phone (631) 433-5098

Other names 1

  • Ms. Jessica Frances Entenman 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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
658179NYMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1114205754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WATERVILLE DR",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117892138",
            "telephone_number": "631-433-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 WATERVILLE DR",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117892138",
            "telephone_number": "631-433-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOAGYE",
        "first_name": "JESSICA",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "R.N., B.S.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "658179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ENTENMAN",
            "middle_name": "FRANCES",
            "prefix": "MS.",
            "credential": "L.P.N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sound Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.