Individual provider Active NPI

Brenna Lela Forbes

  • Licensed Practical Nurse
  • Central Islip, NY
National Provider Identifier
1811861313
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
347294-01 Issued in NY
Practice address
485 Clayton Street
Central Islip, NY 11722-3003
Phone
(631) 233-9633
NPI assigned
Sep 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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 347294-01 NY Primary

Addresses

Primary practice location

485 Clayton Street
Central Islip, NY 11722-3003

Mailing address

485 Clayton Street
Central Islip, NY 11722-3003
Phone (631) 233-9633

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
347294-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1811861313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 CLAYTON STREET",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117223003",
            "telephone_number": "631-233-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 CLAYTON STREET",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117223003",
            "telephone_number": "631-233-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "BRENNA",
        "middle_name": "LELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "347294-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.