Individual provider Active NPI

Eric John Jansen, RN

  • Administrator Registered Nurse
  • Rochester, NY
National Provider Identifier
1184094732
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
424870-1 Issued in NY
Practice address
339 East Ave
Suite 303
Rochester, NY 14604-2627
Phone
(585) 434-2633
Fax
(585) 434-2635
NPI assigned
Sep 25, 2015
Last updated
Sep 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 424870-1 NY Primary

Addresses

Primary practice location

339 East Ave
Suite 303
Rochester, NY 14604-2627

Mailing address

339 East Ave
Suite 303
Rochester, NY 14604-2627
Phone (585) 434-2633

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
424870-1NYMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1184094732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 EAST AVE",
            "address_2": "SUITE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146042627",
            "telephone_number": "585-434-2633",
            "fax_number": "585-434-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 EAST AVE",
            "address_2": "SUITE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146042627",
            "telephone_number": "585-434-2633",
            "fax_number": "585-434-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "424870-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.