Individual provider Active NPI

Melbourne Wellesley Foster, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1366784795
Registry record updated Mar 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
10-295352 Issued in NY
Practice address
1765 Troy Ave
Brooklyn, NY 11234-2029
Phone
(347) 303-8097
NPI assigned
Mar 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 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 10-295352 NY Primary

Addresses

Primary practice location

1765 Troy Ave
Brooklyn, NY 11234-2029

Mailing address

1765 Troy Ave
Brooklyn, NY 11234-2029
Phone (347) 303-8097

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
10-295352NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364083200000",
    "number": "1366784795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 TROY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342029",
            "telephone_number": "347-303-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 TROY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342029",
            "telephone_number": "347-303-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "MELBOURNE",
        "middle_name": "WELLESLEY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-24",
        "last_updated": "2013-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10-295352",
            "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 Mar 24, 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.