Individual provider Active NPI

Stephania Thevenot, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1891438453
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
334614-01 Issued in NY
Practice address
2 Paerdegat 15TH St
Brooklyn, NY 11236-4869
Phone
(929) 535-1875
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 334614-01 NY Primary

Addresses

Primary practice location

2 Paerdegat 15TH St
Brooklyn, NY 11236-4869

Mailing address

2 Paerdegat 15TH St
Brooklyn, NY 11236-4869
Phone (929) 535-1875

Other practice location 1

229 Richmond Ave
West Haven, CT 06516-5200
Phone (929) 535-1875

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
334614-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1891438453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PAERDEGAT 15TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364869",
            "telephone_number": "929-535-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PAERDEGAT 15TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364869",
            "telephone_number": "929-535-1875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "CT",
            "postal_code": "065165200",
            "country_code": "US",
            "telephone_number": "929-535-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEVENOT",
        "first_name": "STEPHANIA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "334614-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.