Individual provider Active NPI

Michelle Lynn Cullen, LPN

  • Licensed Practical Nurse
  • Liverpool, NY
National Provider Identifier
1013198282
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
226500 Issued in NY
Practice address
K7 Cedar Cir
Liverpool, NY 13090-3337
Phone
(315) 409-4929
NPI assigned
Nov 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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 226500 NY Primary

Addresses

Primary practice location

K7 Cedar Cir
Liverpool, NY 13090-3337

Mailing address

K7 Cedar Cir
Liverpool, NY 13090-3337
Phone (315) 409-4929

Other identifiers 1

IdentifierTypeStateIssuer
02215507MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1013198282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "K7 CEDAR CIR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903337",
            "telephone_number": "315-409-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "K7 CEDAR CIR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903337",
            "telephone_number": "315-409-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "226500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02215507",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.