Individual provider Active NPI

Andrea Longchamps, RN BSN

  • School Registered Nurse
  • Fairport, NY
National Provider Identifier
1952765778
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
702420 Issued in NY
Practice address
41 Oconnor Rd
Fairport, NY 14450
Phone
(585) 377-4660
NPI assigned
Apr 7, 2016
Reactivated
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 702420 NY
Pediatric Registered Nurse 163WP0200X 702420 NY
School Registered Nurse 163WS0200X 702420 NY Primary

Addresses

Primary practice location

41 Oconnor Rd
Fairport, NY 14450

Mailing address

41 Oconnor Rd
Fairport, NY 14450-1327

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
702420NYMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1952765778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OCONNOR RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 OCONNOR RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "14450",
            "telephone_number": "585-377-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGCHAMPS",
        "first_name": "ANDREA",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2023-08-23",
        "certification_date": "2023-03-14",
        "deactivation_date": "2023-03-14",
        "reactivation_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "702420",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "702420",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "702420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.