Individual provider Active NPI

Joanette Agatha Janniere

  • Licensed Practical Nurse
  • Cambria Heights, NY
National Provider Identifier
1568615326
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
212933 Issued in NY
Practice address
11571 226TH St
Cambria Heights, NY 11411-1426
Phone
(347) 256-6453
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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 212933 NY Primary

Addresses

Primary practice location

11571 226TH St
Cambria Heights, NY 11411-1426

Mailing address

124 Patterson Ave
Hempstead, NY 11550-6537
Phone (347) 256-6453

Other identifiers 1

IdentifierTypeStateIssuer
010556898MedicaidNY

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
212933NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1568615326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 PATTERSON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115506537",
            "telephone_number": "347-256-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11571 226TH ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111426",
            "telephone_number": "347-256-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNIERE",
        "first_name": "JOANETTE",
        "middle_name": "AGATHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "212933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010556898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambria Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.