Individual provider Active NPI

Nikita Schultz

  • Licensed Practical Nurse
  • Olean, NY
National Provider Identifier
1053140590
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
313274 Issued in NY
Practice address
1355 Olean Portville Rd
Olean, NY 14760-9416
Phone
(716) 373-0021
Fax
(716) 373-1710
NPI assigned
Aug 1, 2024
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 313274 NY Primary

Addresses

Primary practice location

1355 Olean Portville Rd
Olean, NY 14760-9416

Mailing address

58 Brooklyn St
Portville, NY 14770-9529
Phone (585) 808-6748

Other identifiers 2

IdentifierTypeStateIssuer
161039939MedicaidNY
161039939OtherNYALL OTHER INSURANCES

Other names 1

  • Nikita Warner Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nschultz@casa-trinity.org

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
313274NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Casa-Trinity, Inc. PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1053140590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BROOKLYN ST",
            "city": "PORTVILLE",
            "state": "NY",
            "postal_code": "147709529",
            "telephone_number": "585-808-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 OLEAN PORTVILLE RD",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147609416",
            "telephone_number": "716-373-0021",
            "fax_number": "716-373-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "NIKITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "313274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161039939",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL OTHER INSURANCES",
            "identifier": "161039939",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nschultz@casa-trinity.org",
            "affiliation": "N",
            "endpointDescription": "Personal Email Address",
            "address_1": "1355 Olean Portville Rd",
            "city": "Olean",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147609416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NIKITA",
            "last_name": "WARNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olean, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.