Waveney Virginia Douglas, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

170906-1 Issued in NY

Practice address

1382 McBride St
Far Rockaway, NY 11691-3005

Phone

(718) 337-3976

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831210004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1382 MCBRIDE ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913005",
            "telephone_number": "718-337-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1382 MCBRIDE ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913005",
            "telephone_number": "718-337-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "WAVENEY",
        "middle_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "170906-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PRACTICAL NURSE",
            "identifier": "170906-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01043329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh Anne Ditchek
• Sarrah Dominique, MD
• Kieran Donnelly, PA-C
• Yocheved Rochel Donowitz, M.S
• Ludentz Dorcelus
• Belma Doyle, D.O
• Dr Lloyd Bardfeld
• Dr. Lloyd a Bardfeld
• Ahuva Drandoff
• Doniel Drandoff, LMFT

• Licensed Practical Nurse in Far Rockaway, NY
• Providers in Far Rockaway, 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 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.