Individual provider Active NPI

Johanne Desire

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1356805279
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
786895 Issued in NY
Practice address
9901 Seaview Ave
Brooklyn, NY 11236-5519
Phone
(347) 353-5177
NPI assigned
Jan 24, 2019
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 786895 NY Primary
Licensed Practical Nurse 164W00000X 309079 NY

Addresses

Primary practice location

9901 Seaview Ave
Brooklyn, NY 11236-5519

Mailing address

9901 Seaview Ave
Brooklyn, NY 11236-5519
Phone (347) 353-5177

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
786895NYMDRegistered Nurse
309079NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1356805279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 SEAVIEW AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365519",
            "telephone_number": "347-353-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 SEAVIEW AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365519",
            "telephone_number": "347-353-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIRE",
        "first_name": "JOHANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "786895",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "309079",
            "primary": false
        }
    ],
    "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 Jun 8, 2020; 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.