Individual provider Active NPI

Debra Grace Newcombe, LPN

  • Licensed Practical Nurse
  • Canandaigua, NY
National Provider Identifier
1417446485
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
306854-1 Issued in NY
Practice address
3832 Middle Cheshire Rd
Canandaigua, NY 14424-8333
Phone
(315) 651-0025
NPI assigned
May 5, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 306854-1 NY Primary

Addresses

Primary practice location

3832 Middle Cheshire Rd
Canandaigua, NY 14424-8333

Mailing address

3832 Middle Cheshire Rd
Canandaigua, NY 14424-8333

Other identifiers 1

IdentifierTypeStateIssuer
05MedicaidNY

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
306854-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1525478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1417446485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3832 MIDDLE CHESHIRE RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3832 MIDDLE CHESHIRE RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248333",
            "telephone_number": "315-651-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMBE",
        "first_name": "DEBRA",
        "middle_name": "GRACE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-05",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "306854-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.