Shawnnel Jewel Jefferson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

320385 Issued in NY

Practice address

65 Hoeltzer St
Rochester, NY 14605-1207

Phone

(585) 520-4229

NPI assigned

Dec 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1720486368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HOELTZER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146051207",
            "telephone_number": "585-520-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HOELTZER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146051207",
            "telephone_number": "585-520-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SHAWNNEL",
        "middle_name": "JEWEL",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "320385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04042426",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Home",
            "affiliation": "N",
            "address_1": "65 Hoeltzer St",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146051207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra H Jee, MD
• Gina M Jeffers, PA
• Jefferson Family Medicine
• Elizabeth M. Jefferson, P.A.
• Maureen Amie Jefferson, LICENSED PRACTICAL N
• Taimka Jefferson, LPN
• Jeffrey a Liberman DO PC
• Jeffrey C. Leathersich PA, PLLC
• Jeffrey I Goldberg DDS PLLC
• Renee Jeffrey, LICENSED PRACTICAL N

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.