Active NPI
Elcie Joachim, RN
- Registered Nurse
- Brentwood, NY
National Provider Identifier
1417148172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 5304631
- Practice address
- 14 Mayflower CT
Brentwood, NY 11717 - Phone
- (631) 231-5475
- NPI assigned
- Aug 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 5304631 | NY | Primary |
Addresses
Primary practice location
14 Mayflower CT
Brentwood, NY 11717
Mailing address
14 Mayflower CT
Brentwood, NY 11717
Phone (631) 231-5475
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02300585 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5304631 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186444800000",
"number": "1417148172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 MAYFLOWER CT",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "11717",
"telephone_number": "631-231-5475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 MAYFLOWER CT",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "11717",
"telephone_number": "631-231-5475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOACHIM",
"first_name": "ELCIE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-07",
"last_updated": "2007-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "5304631",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02300585",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.