Individual provider Active NPI

Latoya Headley, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1750501037
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
281816-1 Issued in NY
Practice address
274 E 32ND St
Brooklyn, NY 11226-6414
Phone
(917) 862-5215
Fax
(718) 347-4643
NPI assigned
Apr 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 281816-1 NY Primary

Addresses

Primary practice location

274 E 32ND St
Brooklyn, NY 11226-6414

Mailing address

35 Tulip Ave
PO Box 20838
Floral Park, NY 11002-0838
Phone (917) 862-5215

Other identifiers 1

IdentifierTypeStateIssuer
02860662MedicaidNY

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
281816-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Leroy Herbert, MD,PC Past 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": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750501037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 TULIP AVE",
            "address_2": "PO BOX 20838",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110020838",
            "telephone_number": "917-862-5215",
            "fax_number": "718-347-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 E 32ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266414",
            "telephone_number": "917-862-5215",
            "fax_number": "718-347-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "LATOYA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "281816-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02860662",
            "state": "NY"
        }
    ],
    "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 Jul 9, 2007; 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.