Jennifer E Street

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

010725-1 Issued in NY

Practice address

9076 North Rd
Bridgeport, NY 13030-9662

Phone

(315) 687-2280

Fax

(315) 687-2281

NPI assigned

Dec 7, 2011

Last updated

Dec 7, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer E Avery Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1154699940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9076 NORTH RD",
            "city": "BRIDGEPORT",
            "state": "NY",
            "postal_code": "130309662",
            "telephone_number": "315-687-2280",
            "fax_number": "315-687-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9076 NORTH RD",
            "city": "BRIDGEPORT",
            "state": "NY",
            "postal_code": "130309662",
            "telephone_number": "315-687-2280",
            "fax_number": "315-687-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NY",
            "license": "010725-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "AVERY",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Elizabeth Ostrander, RN, NNP
• Kristy Lee Dracker Parkin
• Debra Grace Peterson-Smith, LMHC
• Kim M Proper
• Kimberly Michele Sexton
• Syracuse DME LLC
• Timothy Walsh, R.PH.
• Rebecca Wilkowski

• Local Education Agency (LEA) in Bridgeport, NY
• Providers in Bridgeport, NY by specialty
• Local Education Agency (LEA) in New York

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