Individual provider Active NPI

Stephanie Jolicoeur, LPN

  • Licensed Practical Nurse
  • New York, NY
National Provider Identifier
1700255718
Registry record updated Sep 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
322552-1 Issued in NY
Practice address
565 Manhattan Ave
New York, NY 10027-5250
Phone
(212) 222-5958
NPI assigned
Sep 20, 2015
Last updated
Sep 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2015

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 322552-1 NY Primary

Addresses

Primary practice location

565 Manhattan Ave
New York, NY 10027-5250

Mailing address

24138 148TH Dr
Rosedale, NY 11422-3251
Phone (954) 609-1625

Other identifiers 1

IdentifierTypeStateIssuer
KV89013RMedicaidNY

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
322552-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1442707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442707200000",
    "number": "1700255718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24138 148TH DR",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114223251",
            "telephone_number": "954-609-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 MANHATTAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275250",
            "telephone_number": "212-222-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLICOEUR",
        "first_name": "STEPHANIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-20",
        "last_updated": "2015-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "322552-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KV89013R",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2015; 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.