Individual provider Active NPI

Cleotielde Nadia Rock

  • Licensed Practical Nurse
  • Yonkers, NY
National Provider Identifier
1972179364
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
179349-1 Issued in NY
Practice address
317 S Broadway
Yonkers, NY 10705-2008
Phone
(914) 965-5305
Fax
(914) 963-7187
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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 179349-1 NY Primary

Addresses

Primary practice location

317 S Broadway
Yonkers, NY 10705-2008

Mailing address

317 S Broadway
Yonkers, NY 10705-2008
Phone (914) 965-5305

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
179349-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1972179364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107052008",
            "telephone_number": "914-965-5305",
            "fax_number": "914-963-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107052008",
            "telephone_number": "914-965-5305",
            "fax_number": "914-963-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "CLEOTIELDE",
        "middle_name": "NADIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "179349-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.