Jessica Anne Lindberg, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

240431 Issued in NY

Practice address

201 Avenue a
Port Jefferson, NY 11777-1877

Phone

(631) 828-1439

Fax

(631) 910-2096

NPI assigned

May 29, 2019

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

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1881252542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 AVENUE A",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771877",
            "telephone_number": "631-828-1439",
            "fax_number": "631-910-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 AVENUE A",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771877",
            "telephone_number": "631-828-1439",
            "fax_number": "631-910-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBERG",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "240431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lighthouse Integrative Counseling Services LCSW Marriage and Family TH
• Dorothy Marie Lilly, RLCSW
• Erin Lim, DO
• Brendon Lin, MD
• Nathaniel Lin
• Frank Archie Lindner, LMHC
• Scott Richard Lindsay, PT, DPT
• Anne Lins, RN
• Ross Eliott Lipton, M.D.
• Ariella Lissauer, M.D.

• Licensed Practical Nurse in Port Jefferson, NY
• Providers in Port Jefferson, 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 May 29, 2019; 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.