Individual provider Active NPI

Ivy Beauvais, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1124352729
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
280849-1 Issued in NY
Practice address
1480 E 94TH St
Brooklyn, NY 11236-5010
Phone
(347) 262-9310
Fax
(718) 629-0949
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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 280849-1 NY Primary

Addresses

Primary practice location

1480 E 94TH St
Brooklyn, NY 11236-5010

Mailing address

1480 E 94TH St
Brooklyn, NY 11236-5010
Phone (347) 262-9310

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
280849-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1124352729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 E 94TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365010",
            "telephone_number": "347-262-9310",
            "fax_number": "718-629-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 E 94TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365010",
            "telephone_number": "347-262-9310",
            "fax_number": "718-629-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUVAIS",
        "first_name": "IVY",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "280849-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.