Individual provider Active NPI

Jessica Medranda, RN

  • Registered Nurse
  • Valhalla, NY
National Provider Identifier
1669911855
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
696892-1 Issued in NY
Practice address
503 Grasslands Rd
Valhalla, NY 10595-1503
Phone
(914) 593-0593
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 696892-1 NY Primary

Addresses

Primary practice location

503 Grasslands Rd
Valhalla, NY 10595-1503

Mailing address

36 Vredenburgh Street
2
Yonkers, NY 10704
Phone (914) 819-3565

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
696892-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1669911855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 VREDENBURGH STREET",
            "address_2": "2",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10704",
            "telephone_number": "914-819-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 GRASSLANDS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951503",
            "telephone_number": "914-593-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANDA",
        "first_name": "JESSICA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "696892-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.