Individual provider Active NPI

Leslie Marie Freeman, L.P.N.

  • Licensed Practical Nurse
  • Valley Stream, NY
National Provider Identifier
1508125964
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
291204-1 Issued in NY
Practice address
161 Ocean Ave FL 2
Valley Stream, NY 11580
Phone
(516) 850-9379
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 291204 NY
Licensed Practical Nurse 164W00000X 291204-1 NY Primary

Addresses

Primary practice location

161 Ocean Ave FL 2
Valley Stream, NY 11580

Mailing address

161 Ocean Ave FL 2
Valley Stream, NY 11580-2934
Phone (516) 850-9379

Other practice location 1

195 Broadway
Lawrence, NY 11559
Phone (516) 295-7000

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

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
291204NYMDLicensed Practical Nurse
291204-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1508125964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 OCEAN AVE FL 2",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802934",
            "telephone_number": "516-850-9379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 OCEAN AVE FL 2",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-850-9379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "195 Broadway",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "NY",
            "postal_code": "11559",
            "country_code": "US",
            "telephone_number": "516-295-7000",
            "fax_number": "516-295-7196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "LESLIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "291204",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "291204-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.