Individual provider Active NPI

Jacqueline J Bracy, R.N.

  • Registered Nurse
  • Plattsburgh, NY
National Provider Identifier
1407125461
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
409072-1 Issued in NY
Practice address
50 Bailey Ave
Plattsburgh, NY 12901-1445
Phone
(518) 563-4190
Fax
(518) 566-7663
NPI assigned
Dec 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 409072-1 NY Primary

Addresses

Primary practice location

50 Bailey Ave
Plattsburgh, NY 12901-1445

Mailing address

50 Bailey Ave
Plattsburgh, NY 12901-1445
Phone (518) 563-4190

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
409072-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1407125461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BAILEY AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011445",
            "telephone_number": "518-563-4190",
            "fax_number": "518-566-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BAILEY AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011445",
            "telephone_number": "518-563-4190",
            "fax_number": "518-566-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACY",
        "first_name": "JACQUELINE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "409072-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.