Individual provider Active NPI

Tracey Deschamps, LPN

  • Licensed Practical Nurse
  • Elmont, NY
National Provider Identifier
1962795617
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
305204-1 Issued in NY
Practice address
66 Norfolk Dr W
Elmont, NY 11003-4814
Phone
(718) 593-9061
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2011

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 305204-1 NY Primary

Addresses

Primary practice location

66 Norfolk Dr W
Elmont, NY 11003-4814

Mailing address

66 Norfolk Dr W
Elmont, NY 11003-4814
Phone (718) 593-9061

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
305204-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1962795617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 NORFOLK DR W",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034814",
            "telephone_number": "718-593-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 NORFOLK DR W",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034814",
            "telephone_number": "718-593-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESCHAMPS",
        "first_name": "TRACEY",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305204-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.