Individual provider Active NPI

Yacira Jasmine Jardine, R.N

  • Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1518107994
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
597383-1 Issued in NY
Practice address
138 Delaware Ave
Bay Shore, NY 11706-3213
Phone
(631) 666-6983
NPI assigned
Feb 25, 2009
Last updated
Feb 25, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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 597383-1 NY Primary

Addresses

Primary practice location

138 Delaware Ave
Bay Shore, NY 11706-3213

Mailing address

138 Delaware Ave
Bay Shore, NY 11706-3213
Phone (631) 666-6983

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
597383-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1518107994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 DELAWARE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063213",
            "telephone_number": "631-666-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 DELAWARE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063213",
            "telephone_number": "631-666-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "YACIRA",
        "middle_name": "JASMINE",
        "credential": "R.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "597383-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.