Individual provider Active NPI

Israelite Nazaire, LVN

  • Licensed Practical Nurse
  • Round Rock, TX
National Provider Identifier
1912651704
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
300458 Issued in TX
Practice address
3304 Balboa Way
Round Rock, TX 78665-2252
Phone
(512) 600-3383
Fax
(512) 856-9483
NPI assigned
Feb 9, 2022
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 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 300458 TX Primary

Addresses

Primary practice location

3304 Balboa Way
Round Rock, TX 78665-2252

Mailing address

3304 Balboa Way
Round Rock, TX 78665-2252
Phone (512) 600-3383

Other names 1

  • Israelite Nazaire Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL roundrockhomehealthservice.com Direct

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
300458TXMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nazcare LLC CurrentSince Feb 13, 2022 Accepting new patients
Nazcare LLC PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1912651704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 BALBOA WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652252",
            "telephone_number": "512-600-3383",
            "fax_number": "512-856-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 BALBOA WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652252",
            "telephone_number": "512-600-3383",
            "fax_number": "512-856-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZAIRE",
        "first_name": "ISRAELITE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "300458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "roundrockhomehealthservice.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3304 Balboa Way",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786652252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ISRAELITE",
            "last_name": "NAZAIRE",
            "credential": "LVN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.