Individual provider Active NPI

Carmelle Marie Jourdain

  • Licensed Practical Nurse
  • Queens Village, NY
National Provider Identifier
1124327473
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
263379-1 Issued in NY
Practice address
10450 214TH St
Queens Village, NY 11429-1543
Phone
(917) 225-9954
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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 263379-1 NY Primary

Addresses

Primary practice location

10450 214TH St
Queens Village, NY 11429-1543

Mailing address

10450 214TH St
Queens Village, NY 11429-1543
Phone (917) 225-9954

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
263379-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1124327473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 214TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291543",
            "telephone_number": "917-225-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 214TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291543",
            "telephone_number": "917-225-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOURDAIN",
        "first_name": "CARMELLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "263379-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.