Individual provider Active NPI

Eddy S Jean-Baptiste, NURSING CARE,RN

  • Licensed Practical Nurse
  • Pittsford, NY
National Provider Identifier
1609045046
Registry record updated May 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
285771-1 Issued in NY
Practice address
19 Kitty Hawk Dr
Pittsford, NY 14534-1620
Phone
(585) 381-7852
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2014

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 285771-1 NY Primary
Rehabilitation Registered Nurse 163WR0400X 641225 NY

Addresses

Primary practice location

19 Kitty Hawk Dr
Pittsford, NY 14534-1620

Mailing address

19 Kitty Hawk Dr
Pittsford, NY 14534-1620
Phone (585) 381-7852

Other identifiers 1

IdentifierTypeStateIssuer
NPI: 1609045046MedicaidNY

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
641225NYMDRehabilitation Registered Nurse
285771-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400284800000",
    "number": "1609045046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 KITTY HAWK DR",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341620",
            "telephone_number": "585-381-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 KITTY HAWK DR",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341620",
            "telephone_number": "585-381-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-BAPTISTE",
        "first_name": "EDDY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "NURSING CARE,RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2014-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "285771-1",
            "primary": true
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "NY",
            "license": "641225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPI: 1609045046",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2014; 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.