Individual provider Active NPI

Daphnee Innocent, LPN

  • Licensed Practical Nurse
  • Bay Shore, NY
National Provider Identifier
1730467010
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
306000 Issued in NY
Practice address
147 Rhode Island Ave
Bay Shore, NY 11706-3346
Phone
(631) 522-8979
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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 306000 NY Primary

Addresses

Primary practice location

147 Rhode Island Ave
Bay Shore, NY 11706-3346

Mailing address

147 Rhode Island Avenue
Bay Shore, NY 11706
Phone (631) 522-8979

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
306000NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1730467010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 RHODE ISLAND AVENUE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-522-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 RHODE ISLAND AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063346",
            "telephone_number": "631-522-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNOCENT",
        "first_name": "DAPHNEE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "306000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.