Individual provider Active NPI

Chioma C J Ibe Pearson

  • Registered Nurse
  • Mount Vernon, NY
National Provider Identifier
1205225638
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
670457-1 Issued in NY
Practice address
26 S 14TH Ave
Mount Vernon, NY 10550-2845
Phone
(347) 430-0818
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 670457-1 NY Primary

Addresses

Primary practice location

26 S 14TH Ave
Mount Vernon, NY 10550-2845

Mailing address

26 S 14TH Ave
Mount Vernon, NY 10550-2845
Phone (347) 430-0818

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
670457-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1205225638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S 14TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502845",
            "telephone_number": "347-430-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S 14TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502845",
            "telephone_number": "347-430-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBE PEARSON",
        "first_name": "CHIOMA",
        "middle_name": "C J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "670457-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.