Jamie Tavernier, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

554156-01 Issued in NY

Practice address

31 6TH St
Malone, NY 12953-1246

Phone

(518) 651-4822

Fax

(518) 483-3383

NPI assigned

Nov 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jamie Bergeron Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Citizen Advocates, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Malone, NY
  • NPI 1477765733
  NPD
• Citizen Advocates, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  NPD

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1861101818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W MAIN ST",
            "city": "CHATEAUGAY",
            "state": "NY",
            "postal_code": "129202900",
            "telephone_number": "518-651-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 6TH ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531246",
            "telephone_number": "518-651-4822",
            "fax_number": "518-483-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNIER",
        "first_name": "JAMIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "554156-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "554156-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "026.0146584",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "BERGERON",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shara Tacchino
• Jordan Tague
• Makensy Kay Tallman, REGISTERED NURSE
• Felix Tam, P.T.
• Alyssa Tatro, DPT
• Lynne Taylor, MS NCC
• Yasmina Tbeur, M.D.
• Randi Tella
• Peter Randolph Terrance, BSW
• The Farrar Home

• Registered Nurse in Malone, NY
• Providers in Malone, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.