Individual provider Active NPI

Jeffry V Uecker, LVN

  • Licensed Vocational Nurse
  • Crescent City, CA
National Provider Identifier
1467572271
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN 172944 Issued in CA
Practice address
206 Williams Dr
Crescent City, CA 95531-8301
Phone
(707) 464-7224
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN 172944 CA Primary

Addresses

Primary practice location

206 Williams Dr
Crescent City, CA 95531-8301

Mailing address

220 W Condor St
Crescent City, CA 95531-3343
Phone (707) 464-5159

Other identifiers 1

IdentifierTypeStateIssuer
VN 172944OtherCALICENSE VOCATIONAL NURSE

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
VN 172944CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467572271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W CONDOR ST",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955313343",
            "telephone_number": "707-464-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 WILLIAMS DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318301",
            "telephone_number": "707-464-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UECKER",
        "first_name": "JEFFRY",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN 172944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE VOCATIONAL NURSE",
            "identifier": "VN 172944",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

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.

Verify at the official NPI Registry.