Individual provider Active NPI

Yvonne Eloise Bedward

  • Gerontology Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1154604221
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F340582-1 Issued in NY
Practice address
23222 143Rd Ave
Jamaica, NY 11413-3601
Phone
(347) 335-7461
NPI assigned
Sep 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F340582-1 NY Primary

Addresses

Primary practice location

23222 143Rd Ave
Jamaica, NY 11413-3601

Mailing address

23222 143Rd Ave
Jamaica, NY 11413-3601
Phone (347) 335-7461

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
F340582-1NYMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1154604221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23222 143RD AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114133601",
            "telephone_number": "347-335-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23222 143RD AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114133601",
            "telephone_number": "347-335-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDWARD",
        "first_name": "YVONNE",
        "middle_name": "ELOISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340582-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.