Individual provider Active NPI

Jessica Pooda, LPN

  • Licensed Practical Nurse
  • Watertown, NY
National Provider Identifier
1740195460
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
357455 Issued in NY
Practice address
611 W Main St
Watertown, NY 13601-1337
Phone
(315) 782-1777
NPI assigned
Aug 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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 357455 NY Primary

Addresses

Primary practice location

611 W Main St
Watertown, NY 13601-1337

Mailing address

1215 Faichney Dr Apt 5
Watertown, NY 13601-1882
Phone (315) 782-1777

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Wellness and Recovery, Inc PastSince Aug 11, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1740195460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 FAICHNEY DR APT 5",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011882",
            "telephone_number": "315-782-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011337",
            "telephone_number": "315-782-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POODA",
        "first_name": "JESSICA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "357455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.