Shawntay Jacques, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

299755 Issued in NY

Practice address

218-25 132ND Ave
Laurelton, NY 11413

Phone

(718) 712-4422

NPI assigned

Jul 7, 2010

Last updated

Nov 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Shawntay Brown Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1750693727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218-25 132ND AVE",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "11413",
            "telephone_number": "718-712-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218-25 132ND AVE",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "11413",
            "telephone_number": "718-712-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "SHAWNTAY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "299755",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "299755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNTAY",
            "last_name": "BROWN",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pauline Veronica Illidge
• Stella Ineama
• Island Musculoskeletal Care, M.D., P.C
• Chisom Iwuanyanwu, O.D
• Olivia Monica Jackson
• Adlie Jacquitte
• Kellee James, CHES
• Shantell E Jay
• Yves Moliere Jean Louis, N.M.D; M.P.H
• Carleen Jean-Felix, LMSW

• Licensed Practical Nurse in Laurelton, NY
• Providers in Laurelton, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.