Individual provider Active NPI

Jovanie Bethana Casimir Charles

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1114633369
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
337324 Issued in NY
Practice address
26 Dumont Ave
Staten Island, NY 10305-1450
Phone
(718) 667-8510
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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 337324 NY Primary

Addresses

Primary practice location

26 Dumont Ave
Staten Island, NY 10305-1450

Mailing address

5 Normandy Ter
West Orange, NJ 07052-2716
Phone (917) 803-8457

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
337324NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1114633369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NORMANDY TER",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522716",
            "telephone_number": "917-803-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 DUMONT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051450",
            "telephone_number": "718-667-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASIMIR CHARLES",
        "first_name": "JOVANIE",
        "middle_name": "BETHANA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "337324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.