Individual provider Active NPI

Shereka Moyalee Bailey, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1205193091
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
309275 Issued in NY
Practice address
594 Ashford St
Brooklyn, NY 11207-5602
Phone
(646) 591-7824
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 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 309275 NY Primary

Addresses

Primary practice location

594 Ashford St
Brooklyn, NY 11207-5602

Mailing address

554 Ashford St
Brooklyn, NY 11207-4901
Phone (646) 591-7824

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
309275NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1205193091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 ASHFORD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112074901",
            "telephone_number": "646-591-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 ASHFORD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075602",
            "telephone_number": "646-591-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SHEREKA",
        "middle_name": "MOYALEE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "309275",
            "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 Apr 18, 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.