Active NPI
Shirlette Wisdom, LPN
- Licensed Practical Nurse
- Yonkers, NY
National Provider Identifier
1760880975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 305469-1
- Practice address
- 1100 Warburton Ave
4P
Yonkers, NY 10701-1052 - Phone
- (914) 720-3452
- NPI assigned
- Dec 22, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 305469-1 | NY | Primary |
Addresses
Primary practice location
1100 Warburton Ave
4P
Yonkers, NY 10701-1052
Mailing address
1126 East 125TH Street
Bronx, NY 10469
Phone (718) 925-5055
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
| License | State | Type | Specialty |
|---|---|---|---|
| 305469-1 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taylored Care Incorporated | Licensed Practical Nurse | 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": "1419206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420675200000",
"number": "1760880975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 EAST 125TH STREET",
"city": "BRONX",
"state": "NY",
"postal_code": "10469",
"telephone_number": "718-925-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WARBURTON AVE",
"address_2": "4P",
"city": "YONKERS",
"state": "NY",
"postal_code": "107011052",
"telephone_number": "914-720-3452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISDOM",
"first_name": "SHIRLETTE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-22",
"last_updated": "2015-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "305469-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.