Individual provider Active NPI

Immacula Pierre Louis Sr.

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1689094476
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
3156731 Issued in NY
Practice address
577 E 82ND St
Brooklyn, NY 11236-3118
Phone
(917) 673-9283
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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 3156731 NY Primary

Addresses

Primary practice location

577 E 82ND St
Brooklyn, NY 11236-3118

Mailing address

577 E 82ND St
Brooklyn, NY 11236-3118
Phone (917) 673-9283

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
3156731NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1689094476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 E 82ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363118",
            "telephone_number": "917-673-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 E 82ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363118",
            "telephone_number": "917-673-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE LOUIS",
        "first_name": "IMMACULA",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "3156731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.