Individual provider Active NPI

Lakeisha N Tennyson

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1740752922
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
334165-1 Issued in NY
Practice address
22 Shafer St
Rochester, NY 14609-4937
Phone
(585) 730-4343
NPI assigned
Dec 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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 334165-1 NY Primary

Addresses

Primary practice location

22 Shafer St
Rochester, NY 14609-4937

Mailing address

22 Shafer St
Rochester, NY 14609-4937
Phone (585) 730-4343

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
334165-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1740752922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SHAFER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146094937",
            "telephone_number": "585-730-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SHAFER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146094937",
            "telephone_number": "585-730-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSON",
        "first_name": "LAKEISHA",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "334165-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.