Individual provider Active NPI

Glenda John

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1942621883
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
317042-1 Issued in NY
Practice address
242 Herzl St Apt 2
Brooklyn, NY 11212-4633
Phone
(347) 567-1294
NPI assigned
Dec 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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 317042-1 NY Primary

Addresses

Primary practice location

242 Herzl St Apt 2
Brooklyn, NY 11212-4633

Mailing address

242 Herzl St Apt 2
Brooklyn, NY 11212-4633
Phone (347) 567-1294

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
317042-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1942621883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 HERZL ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124633",
            "telephone_number": "347-567-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 HERZL ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124633",
            "telephone_number": "347-567-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "GLENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "317042-1",
            "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 Dec 19, 2013; 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.