Individual provider Active NPI

Denise Whisner, LPN

  • Licensed Practical Nurse
  • Jamestown, NY
National Provider Identifier
1417470071
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
261323-1 Issued in NY
Practice address
890 E 2ND St
Jamestown, NY 14701-3824
Phone
(716) 661-1510
Fax
(711) 666-1534
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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 261323-1 NY Primary

Addresses

Primary practice location

890 E 2ND St
Jamestown, NY 14701-3824

Mailing address

200 Dunham Ave
Jamestown, NY 14701-2528
Phone (716) 661-1510

Other identifiers 1

IdentifierTypeStateIssuer
261323-1OtherNYSTATE LICENSE

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
261323-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1417470071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DUNHAM AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012528",
            "telephone_number": "716-661-1510",
            "fax_number": "716-661-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 E 2ND ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147013824",
            "telephone_number": "716-661-1510",
            "fax_number": "711-666-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISNER",
        "first_name": "DENISE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "261323-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "261323-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.