Joanne Vicaretti

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

105687 Issued in NY

Practice address

20 W King St
Port Jervis, NY 12771-3061

Phone

(845) 858-1316

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1952913238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 SHINHOLLOW RD",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127713822",
            "telephone_number": "914-850-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W KING ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127713061",
            "telephone_number": "845-858-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICARETTI",
        "first_name": "JOANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "105687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Safety(i)Private",
            "affiliation": "N",
            "endpointDescription": "i drive",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20 W King St",
            "city": "Port Jervis",
            "state": "NY",
            "country_code": "US",
            "postal_code": "127713061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Twin Rivers Gastroenterology, LLP
• Caroline Ellen Van Patten, M.S., CCC-SLP
• Breanna Nicole Vandyk, NP
• Jessica Velez
• Janice Vicaretti
• Christine Vigilio, RN
• Jessica Vitolano
• Carmen Teresa Wager, RPH
• Danielle Ashley Waldron, PHARM.D.
• Walgreen Co

• Licensed Practical Nurse in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.