Individual provider Active NPI

Shirley Schue, ARNP

  • Pediatric Nurse Practitioner
  • Cooperstown, NY
National Provider Identifier
1003086745
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3822115 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-6982
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3822115 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-6982

Other identifiers 1

IdentifierTypeStateIssuer
302032100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331000496 NY Practitioner - Nurse Practitioner 8325174196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3822115NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Mar 1, 2010 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Mar 1, 2010 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Interoperability endpoints

  • Direct secure messaging: sschue5900@bassett.direct-ci.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1003086745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUE",
        "first_name": "SHIRLEY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "3822115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302032100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.