Individual provider Active NPI

Youseline Champagne, R.N.

  • Registered Nurse
  • Coram, NY
National Provider Identifier
1427213792
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
543565-1 Issued in NY
Practice address
77 Birchwood Rd
Coram, NY 11727-3680
Phone
(718) 813-3762
NPI assigned
Jul 25, 2008
Last updated
Jul 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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 543565-1 NY Primary

Addresses

Primary practice location

77 Birchwood Rd
Coram, NY 11727-3680

Mailing address

77 Birchwood Rd
Coram, NY 11727-3680
Phone (718) 813-3762

Other identifiers 1

IdentifierTypeStateIssuer
543565-1MedicaidNY

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
543565-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1427213792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BIRCHWOOD RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117273680",
            "telephone_number": "718-813-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BIRCHWOOD RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117273680",
            "telephone_number": "718-813-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "YOUSELINE",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "543565-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "543565-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.