Individual provider Active NPI

Elica Kimlyn James-Douglas

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1699440719
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
791627 Issued in NY
Practice address
1312 Caton Ave
Brooklyn, NY 11226-1099
Phone
(718) 693-7000
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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 791627 NY Primary

Addresses

Primary practice location

1312 Caton Ave
Brooklyn, NY 11226-1099

Mailing address

41 E 29TH St Apt D3
Brooklyn, NY 11226-5076
Phone (929) 330-1461

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
791627NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1699440719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E 29TH ST APT D3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112265076",
            "telephone_number": "929-330-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 CATON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261099",
            "telephone_number": "718-693-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES-DOUGLAS",
        "first_name": "ELICA",
        "middle_name": "KIMLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "791627",
            "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 Aug 11, 2021; 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.