Individual provider Active NPI

Nelca Jean

  • Licensed Practical Nurse
  • Rosedale, NY
National Provider Identifier
1609132158
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
306547 Issued in NY
Practice address
24520 148TH Ave
Rosedale, NY 11422-2416
Phone
(718) 525-7196
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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 306547 NY Primary

Addresses

Primary practice location

24520 148TH Ave
Rosedale, NY 11422-2416

Mailing address

24520 148TH Ave
Rosedale, NY 11422-2416
Phone (718) 525-7196

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
306547NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1609132158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24520 148TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222416",
            "telephone_number": "718-525-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24520 148TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222416",
            "telephone_number": "718-525-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "NELCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "306547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.