Individual provider Active NPI

Persha Jean Lettman, LPN

  • Licensed Practical Nurse
  • Flushing, NY
National Provider Identifier
1306161385
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
242741 Issued in NY
Practice address
4566 162ND St
Suite 1
Flushing, NY 11358-3158
Phone
(718) 539-8044
Fax
(718) 539-8045
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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 242741 NY Primary

Addresses

Primary practice location

4566 162ND St
Suite 1
Flushing, NY 11358-3158

Mailing address

4566 162ND St
Suite 1
Flushing, NY 11358-3158
Phone (718) 539-8044

Other identifiers 1

IdentifierTypeStateIssuer
1609042175MedicaidNY

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
242741NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dels Comprehensive Health Care Registry Agency,Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1306161385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 162ND ST",
            "address_2": "SUITE 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583158",
            "telephone_number": "718-539-8044",
            "fax_number": "718-539-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 162ND ST",
            "address_2": "SUITE 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583158",
            "telephone_number": "718-539-8044",
            "fax_number": "718-539-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTMAN",
        "first_name": "PERSHA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "242741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609042175",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.