Individual provider Active NPI

Charisse Persaud, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1740506161
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
300513 Issued in NY
Practice address
1256 E 103Rd St
Brooklyn, NY 11236-4502
Phone
(718) 671-2100
NPI assigned
Apr 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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 300513 NY Primary

Addresses

Primary practice location

1256 E 103Rd St
Brooklyn, NY 11236-4502

Mailing address

1256 E 103Rd St
Brooklyn, NY 11236-4502
Phone (718) 671-2100

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
300513NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1740506161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 E 103RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364502",
            "telephone_number": "718-671-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 E 103RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364502",
            "telephone_number": "718-671-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "CHARISSE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "300513",
            "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 Apr 9, 2010; 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.