Active NPI
Kim West
- Early Intervention Provider Agency
- Jamaica, NY
National Provider Identifier
1538538798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- License
- 086453851
- Practice address
- 11017 179TH St
Jamaica, NY 11433-3505 - Phone
- (917) 546-6851
- NPI assigned
- Sep 17, 2015
- 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 |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 086453851 | NY | Primary |
Addresses
Primary practice location
11017 179TH St
Jamaica, NY 11433-3505
Mailing address
11017 179TH St
Jamaica, NY 11433-3505
Phone (917) 546-6851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086453851 | Other | NY | SPECIAL EDUCATION |
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 |
|---|---|---|---|
| 086453851 | NY | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442448000000",
"number": "1538538798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11017 179TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114333505",
"telephone_number": "917-546-6851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11017 179TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114333505",
"telephone_number": "917-546-6851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEST",
"first_name": "KIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-17",
"last_updated": "2015-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NY",
"license": "086453851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIAL EDUCATION",
"identifier": "086453851",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.