Individual provider Active NPI

Odertson Jean Francois

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1548149149
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
296754 Issued in NY
Practice address
32 Kenilworth PL
Brooklyn, NY 11210-2328
Phone
(516) 884-4889
NPI assigned
Aug 28, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 296754 NY Primary

Addresses

Primary practice location

32 Kenilworth PL
Brooklyn, NY 11210-2328

Mailing address

32 Kenilworth PL
Brooklyn, NY 11210-2328
Phone (516) 884-4889

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
296754NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1548149149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 KENILWORTH PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102328",
            "telephone_number": "516-884-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 KENILWORTH PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102328",
            "telephone_number": "516-884-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN FRANCOIS",
        "first_name": "ODERTSON",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "296754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.