Individual provider Active NPI

Nissy Rajan

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1477805968
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
638342 Issued in TX
Practice address
2506 W Mount Houston Rd
Houston, TX 77038-3518
Phone
(281) 847-1133
Fax
(281) 847-1167
NPI assigned
Oct 8, 2012
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 638342 TX Primary

Addresses

Primary practice location

2506 W Mount Houston Rd
Houston, TX 77038-3518

Mailing address

2506 W Mount Houston Rd
Houston, TX 77038-3518
Phone (281) 847-1133

Other names 1

  • Lissy John Other name

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
638342TXMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1477805968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 W MOUNT HOUSTON RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770383518",
            "telephone_number": "281-847-1133",
            "fax_number": "281-847-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 W MOUNT HOUSTON RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770383518",
            "telephone_number": "281-847-1133",
            "fax_number": "281-847-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAN",
        "first_name": "NISSY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "638342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISSY",
            "last_name": "JOHN",
            "credential": "APN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.