Individual provider Active NPI

Michele Lynn Brean, LPN

  • Licensed Practical Nurse
  • West Chazy, NY
National Provider Identifier
1215213079
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
254987-1 Issued in NY
Practice address
38 Academy St
West Chazy, NY 12992-3535
Phone
(518) 493-4041
NPI assigned
Oct 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 254987-1 NY Primary

Addresses

Primary practice location

38 Academy St
West Chazy, NY 12992-3535

Mailing address

38 Academy St
West Chazy, NY 12992-3535
Phone (518) 493-4041

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
254987-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1215213079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 ACADEMY ST",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129923535",
            "telephone_number": "518-493-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 ACADEMY ST",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129923535",
            "telephone_number": "518-493-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAN",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "254987-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chazy, NY

Sources for this page

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