Active NPI
Jessica Defayette
- Registered Nurse
- Malone, NY
National Provider Identifier
1962015917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 796743
- Practice address
- 15 4TH St
Malone, NY 12953-1340 - Phone
- (518) 481-8162
- Fax
- (518) 481-8161
- NPI assigned
- Aug 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 796743 | NY | Primary |
Addresses
Primary practice location
15 4TH St
Malone, NY 12953-1340
Mailing address
15 4TH St
Malone, NY 12953-1340
Phone (518) 481-8162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163W00000X | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jessicadefayette@citizensadvocate.es | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 796743 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1962015917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 4TH ST",
"city": "MALONE",
"state": "NY",
"postal_code": "129531340",
"telephone_number": "518-481-8162",
"fax_number": "518-481-8161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 4TH ST",
"city": "MALONE",
"state": "NY",
"postal_code": "129531340",
"telephone_number": "518-481-8162",
"fax_number": "518-481-8161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFAYETTE",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-28",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "796743",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163W00000X",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jessicadefayette@citizensadvocate.es",
"affiliation": "N",
"endpointDescription": "crisis center",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "15 4th St",
"city": "Malone",
"state": "NY",
"country_code": "US",
"postal_code": "129531340",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Malone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.