Individual provider Active NPI

Jennifer Noelle Watts

  • Licensed Practical Nurse
  • North Merrick, NY
National Provider Identifier
1992037030
Registry record updated Jan 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
286210 Issued in NY
Practice address
1917 Meadowbrook Rd
North Merrick, NY 11566-2928
Phone
(516) 632-5436
NPI assigned
Jan 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2010

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 286210 NY Primary

Addresses

Primary practice location

1917 Meadowbrook Rd
North Merrick, NY 11566-2928

Mailing address

1917 Meadowbrook Rd
North Merrick, NY 11566-2928
Phone (516) 632-5436

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
286210NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1264809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264809600000",
    "number": "1992037030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 MEADOWBROOK RD",
            "city": "NORTH MERRICK",
            "state": "NY",
            "postal_code": "115662928",
            "telephone_number": "516-632-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 MEADOWBROOK RD",
            "city": "NORTH MERRICK",
            "state": "NY",
            "postal_code": "115662928",
            "telephone_number": "516-632-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "JENNIFER",
        "middle_name": "NOELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-30",
        "last_updated": "2010-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "286210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2010; 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.