Active NPI
Kaliope Goutis
- Nursing Care Agency
- Fort Drum, NY
National Provider Identifier
1003358284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 3178921
- Legal business name
- KALIOPE GOUTIS
- Practice address
- 8323E Middle Lewis Ave
Fort Drum, NY 13603-2024 - Phone
- (727) 946-3963
- NPI assigned
- Nov 5, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kaliope Goutis
- Title
- LPN
- Phone
- (727) 946-3963
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 3178921 | NY | Primary |
Addresses
Primary practice location
8323E Middle Lewis Ave
Fort Drum, NY 13603-2024
Mailing address
8323E Middle Lewis Ave
Fort Drum, NY 13603-2024
Phone (727) 946-3963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03934241 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478304000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1478304000000",
"number": "1003358284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8323E MIDDLE LEWIS AVE",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "136032024",
"telephone_number": "727-946-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8323E MIDDLE LEWIS AVE",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "136032024",
"telephone_number": "727-946-3963"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KALIOPE GOUTIS",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-05",
"last_updated": "2016-11-05",
"status": "A",
"authorized_official_last_name": "GOUTIS",
"authorized_official_first_name": "KALIOPE",
"authorized_official_title_or_position": "LPN",
"authorized_official_telephone_number": "727-946-3963"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "NY",
"license": "3178921",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03934241",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Drum, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.