Individual provider Active NPI

Rachelle Larrieux

  • Licensed Practical Nurse
  • Nyack, NY
National Provider Identifier
1134476435
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
299656 Issued in NY
Practice address
123 Depew Avenue
Nyack, NY 10960
Phone
(845) 675-7705
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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 299656 NY Primary

Addresses

Primary practice location

123 Depew Avenue
Nyack, NY 10960

Mailing address

123 Depew Avenue
Nyack, NY 10960
Phone (845) 675-7705

Other names 1

  • Ms. Rachelle Balogun Professional 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

State licenses

LicenseStateTypeSpecialty
299656NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1134476435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 DEPEW AVENUE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-675-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 DEPEW AVENUE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-675-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRIEUX",
        "first_name": "RACHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "299656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "BALOGUN",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.