Active NPI
Jinneffer Brown
- Licensed Practical Nurse
- Webster, NY
National Provider Identifier
1457569360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 280522-1
- Practice address
- 1019 Wickerton LN
Webster, NY 14580-8553 - Phone
- (585) 202-5523
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 280522-1 | NY | Primary |
Addresses
Primary practice location
1019 Wickerton LN
Webster, NY 14580-8553
Mailing address
258 Squareview LN
Rochester, NY 14626-1867
Phone (585) 414-6630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02736221 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 280522-1 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457569360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 SQUAREVIEW LN",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146261867",
"telephone_number": "585-414-6630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1019 WICKERTON LN",
"city": "WEBSTER",
"state": "NY",
"postal_code": "145808553",
"telephone_number": "585-202-5523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JINNEFFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "280522-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02736221",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Webster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.