Individual provider Active NPI

Nirva Mellisa Pierre, LPN

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1629409263
Registry record updated Dec 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
316674 Issued in NY
Practice address
2054 Tillotson Ave
Bronx, NY 10475-1560
Phone
(718) 671-2100
NPI assigned
Dec 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2013

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 316674 NY Primary

Addresses

Primary practice location

2054 Tillotson Ave
Bronx, NY 10475-1560

Mailing address

24941 147TH Ave
Rosedale, NY 11422-2421
Phone (347) 453-9477

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
316674NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Leaque Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386460800000",
    "number": "1629409263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24941 147TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222421",
            "telephone_number": "347-453-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 TILLOTSON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104751560",
            "telephone_number": "718-671-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "NIRVA",
        "middle_name": "MELLISA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-08",
        "last_updated": "2013-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "316674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2013; 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.