BRANDI POENICKE
Complete NPI Record 1497559686
Registered Nurse in 8459012986, NY

Active since April 04, 2025
M. CLIFFORD MILLER MIDDLE SCHOOL, 65 FORDING PLACE ROAD, 8459012986, NY 12449(845) 901-2986 Get Directions

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Complete NPI Dataset

This page contains the complete raw NPPES record for Brandi Poenicke (NPI 1497559686), an individual registered nurse provider in 8459012986, NY. All 27 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1497559686
Field 1/27
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Field 2/27
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal Name: POENICKE
Field 3/27
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: BRANDI
Field 4/27
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: M. CLIFFORD MILLER MIDDLE SCHOOL
Field 5/27
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address: 65 FORDING PLACE ROAD
Field 6/27
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City Name: 8459012986
Field 7/27
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NY
Field 8/27
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 12449
Field 9/27
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 10/27
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 8459012986
Field 11/27
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider First Line Business Practice Location Address: M. CLIFFORD MILLER MIDDLE SCHOOL
Field 12/27
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: 65 FORDING PLACE ROAD
Field 13/27
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: 8459012986
Field 14/27
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NY
Field 15/27
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 12449
Field 16/27
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 17/27
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8459012986
Field 18/27
The telephone number associated with the location address of the provider being identified.
Provider Gender Code: X
Field 21/27
The code designating the provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 163W00000X
Field 22/27
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 645180
Field 23/27
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: NY
Field 24/27
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 25/27
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Sole Proprietor: N
Field 26/27
Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
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