Individual provider Active NPI

Fleuvio Jean, LPN

  • Licensed Practical Nurse
  • Grand Rapids, MI
National Provider Identifier
1972805687
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703119527 Issued in MI
Practice address
2301 Valleywood Dr SE
G6
Grand Rapids, MI 49546-5707
Phone
(845) 520-1732
Fax
(845) 520-5042
NPI assigned
Dec 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 301917 NY
Licensed Practical Nurse 164W00000X 4703119527 MI Primary

Addresses

Primary practice location

2301 Valleywood Dr SE
G6
Grand Rapids, MI 49546-5707

Mailing address

2301 Valleywood Dr SE
G6
Grand Rapids, MI 49546-5707
Phone (845) 520-1732

Other practice location 1

234 kenedy, dr
spring valley, NY 10977
Phone (845) 459-9150

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
4703119527MIMDLicensed Practical Nurse
301917NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972805687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 VALLEYWOOD DR SE",
            "address_2": "G6",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465707",
            "telephone_number": "845-520-1732",
            "fax_number": "845-520-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 VALLEYWOOD DR SE",
            "address_2": "G6",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465707",
            "telephone_number": "845-520-1732",
            "fax_number": "845-520-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 kenedy, dr",
            "address_purpose": "LOCATION",
            "city": "spring valley",
            "state": "NY",
            "postal_code": "10977",
            "country_code": "US",
            "telephone_number": "845-459-9150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN",
        "first_name": "FLEUVIO",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "301917",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703119527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.