Individual provider Active NPI

Jacqueline Therese Gayle-Brown

  • Registered Nurse
  • Saint Albans, NY
National Provider Identifier
1609189455
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
614103-1 Issued in NY
Practice address
11728 201St St
Saint Albans, NY 11412-3525
Phone
(347) 571-1336
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 614103-1 NY Primary
Registered Nurse 163W00000X 091594 CT

Addresses

Primary practice location

11728 201St St
Saint Albans, NY 11412-3525

Mailing address

117-28 201St Street
Saint Albans, NY 11412-3525
Phone (347) 571-1336

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
091594CTMDRegistered Nurse
614103-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1609189455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117-28 201ST STREET",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123525",
            "telephone_number": "347-571-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11728 201ST ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123525",
            "telephone_number": "347-571-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLE-BROWN",
        "first_name": "JACQUELINE",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "614103-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "091594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.