Individual provider Active NPI

Icilma Softleigh, LPN

  • Licensed Practical Nurse
  • Far Rockaway, NY
National Provider Identifier
1275788515
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
226068 Issued in NY
Practice address
1602 A Caffrey Ave
Far Rockaway, NY 11691
Phone
(718) 471-1494
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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 226068 NY Primary

Addresses

Primary practice location

1602 A Caffrey Ave
Far Rockaway, NY 11691

Mailing address

1602 A Caffrey Ave
Far Rockaway, NY 11691
Phone (718) 471-1494

Other identifiers 1

IdentifierTypeStateIssuer
226068OtherNYNYS NURSING LICENSE

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
226068NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1275788515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 A CAFFREY AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-471-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 A CAFFREY AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-471-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFTLEIGH",
        "first_name": "ICILMA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "226068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS NURSING LICENSE",
            "identifier": "226068",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.