Nicole Lerouge, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

424739 Issued in NY

Practice address

4 Camp Ave
Walton, NY 13856-1404

Phone

(607) 865-6642

NPI assigned

Jun 28, 2019

Last updated

Jun 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1912569070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 E 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291259",
            "telephone_number": "718-998-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CAMP AVE",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561404",
            "telephone_number": "607-865-6642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Camp Ave",
            "address_purpose": "LOCATION",
            "city": "Walton",
            "state": "NY",
            "postal_code": "138561404",
            "country_code": "US",
            "telephone_number": "607-865-6642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEROUGE",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "424739",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "424739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Kammerman, PA
• Sarah Lyn Kellogg, DPT
• Nicholas Knibbs, APRN FNP-C
• Mandy Lambrecht
• Jeanne Lavell
• Michael Robert Lindsay
• Ty A Little, LCSW
• Eirawen Luettgen, ARNP, FNP, ENP
• Kimberly Jean Martin, COTA/L
• Mary Imogene Bassett Hospital (Bassett Healthcare - Walton)

• Registered Nurse in Walton, NY
• Providers in Walton, 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 Jun 28, 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.