Individual provider Active NPI

Carl Henry Jean Gilles

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1255761979
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
678908-1 Issued in NY
Practice address
9507 Glenwood Rd
Brooklyn, NY 11236-3459
Phone
(347) 893-6309
NPI assigned
Nov 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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 678908-1 NY Primary

Addresses

Primary practice location

9507 Glenwood Rd
Brooklyn, NY 11236-3459

Mailing address

9507 Glenwood Rd
Brooklyn, NY 11236-3459
Phone (347) 893-6309

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
678908-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1255761979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9507 GLENWOOD RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363459",
            "telephone_number": "347-893-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9507 GLENWOOD RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363459",
            "telephone_number": "347-893-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN GILLES",
        "first_name": "CARL HENRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "678908-1",
            "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 Nov 15, 2013; 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.