Individual provider Active NPI

Brandi Jennifer Waldron

  • Licensed Practical Nurse
  • Hilton, NY
National Provider Identifier
1790019081
Registry record updated Sep 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
295831 Issued in NY
Practice address
320 Cedar Ter
Hilton, NY 14468-1440
Phone
(585) 392-0057
NPI assigned
Sep 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2009

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 295831 NY Primary

Addresses

Primary practice location

320 Cedar Ter
Hilton, NY 14468-1440

Mailing address

320 Cedar Ter
Hilton, NY 14468-1440
Phone (585) 392-0057

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
295831NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1253404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253404800000",
    "number": "1790019081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CEDAR TER",
            "city": "HILTON",
            "state": "NY",
            "postal_code": "144681440",
            "telephone_number": "585-392-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CEDAR TER",
            "city": "HILTON",
            "state": "NY",
            "postal_code": "144681440",
            "telephone_number": "585-392-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "BRANDI",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-20",
        "last_updated": "2009-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "295831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2009; 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.