Individual provider Active NPI

Janiqua M Davis

  • Licensed Practical Nurse
  • Syracuse, NY
National Provider Identifier
1669769394
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
295170 Issued in NY
Practice address
158 Lynwood Ave
Apt. 1
Syracuse, NY 13206
Phone
(315) 481-0795
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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 295170 NY Primary

Addresses

Primary practice location

158 Lynwood Ave
Apt. 1
Syracuse, NY 13206

Mailing address

158 Lynwood Ave
Apt. 1
Syracuse, NY 13206
Phone (315) 481-0795

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

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1669769394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 LYNWOOD AVE",
            "address_2": "APT. 1",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13206",
            "telephone_number": "315-481-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 LYNWOOD AVE",
            "address_2": "APT. 1",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13206",
            "telephone_number": "315-481-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JANIQUA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "295170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.