Individual provider Active NPI

Joyce Derner, LPN

  • Licensed Practical Nurse
  • Fresh Meadows, NY
National Provider Identifier
1326728718
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
336973 Issued in NY
Practice address
6735A 186TH LN Apt 2B
Fresh Meadows, NY 11365-4401
Phone
(917) 620-5452
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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 336973 NY Primary

Addresses

Primary practice location

6735A 186TH LN Apt 2B
Fresh Meadows, NY 11365-4401

Mailing address

6735A 186TH LN Apt 2B
Fresh Meadows, NY 11365-4401
Phone (917) 620-5452

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
336973NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1326728718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735A 186TH LN APT 2B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654401",
            "telephone_number": "917-620-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735A 186TH LN APT 2B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654401",
            "telephone_number": "917-620-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERNER",
        "first_name": "JOYCE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "336973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.