Individual provider Active NPI

Bhagwattie D. Jaggernauth

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1205158011
Registry record updated Feb 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
292864-1 Issued in NY
Practice address
670 Lincoln PL
Apt.2L
Brooklyn, NY 11216-4432
Phone
(917) 573-7447
NPI assigned
Feb 20, 2010
Last updated
Feb 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2010

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 292864-1 NY Primary

Addresses

Primary practice location

670 Lincoln PL
Apt.2L
Brooklyn, NY 11216-4432

Mailing address

670 Lincoln PL
Apt.2L
Brooklyn, NY 11216-4432
Phone (917) 573-7447

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
292864-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1266624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266624000000",
    "number": "1205158011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LINCOLN PL",
            "address_2": "APT.2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112164432",
            "telephone_number": "917-573-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 LINCOLN PL",
            "address_2": "APT.2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112164432",
            "telephone_number": "917-573-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGERNAUTH",
        "first_name": "BHAGWATTIE",
        "middle_name": "D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-20",
        "last_updated": "2010-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "292864-1",
            "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 Feb 20, 2010; 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.