Active NPI
Shawn Jessamy, L.P.N.
- Licensed Practical Nurse
- New York, NY
National Provider Identifier
1881996171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 303771
- Practice address
- 1148 5TH Ave
New York, NY 10128-0807 - Phone
- (917) 595-0465
- NPI assigned
- Nov 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 303771 | NY | Primary |
Addresses
Primary practice location
1148 5TH Ave
New York, NY 10128-0807
Mailing address
39 Jackson St
Mount Vernon, NY 10553-1746
Phone (917) 595-0465
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
| License | State | Type | Specialty |
|---|---|---|---|
| 303771 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433894400000",
"number": "1881996171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 JACKSON ST",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105531746",
"telephone_number": "917-595-0465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1148 5TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101280807",
"telephone_number": "917-595-0465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSAMY",
"first_name": "SHAWN",
"credential": "L.P.N.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-19",
"last_updated": "2015-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "303771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.