Individual provider Active NPI

Liyuan Jing, RN

  • Registered Nurse
  • Stony Brook, NY
National Provider Identifier
1932767514
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
641561-1 Issued in NY
Practice address
44 Malvern LN
Stony Brook, NY 11790-2849
Phone
(347) 822-8428
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 641561-1 NY Primary

Addresses

Primary practice location

44 Malvern LN
Stony Brook, NY 11790-2849

Mailing address

44 Malvern LN
Stony Brook, NY 11790-2849
Phone (347) 822-8428

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
641561-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1932767514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MALVERN LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902849",
            "telephone_number": "347-822-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 MALVERN LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902849",
            "telephone_number": "347-822-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JING",
        "first_name": "LIYUAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "641561-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.