Individual provider Active NPI

Cecilia Siberon-Sone, ARNP

  • Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1073644035
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1769532 Issued in FL
Practice address
1701 E College Ave
Bloomington, IL 61704-2101
Phone
(309) 665-4729
Fax
(309) 665-4727
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1769532 FL Primary

Addresses

Primary practice location

1701 E College Ave
Bloomington, IL 61704-2101

Mailing address

15270 SW 57TH St
Miami, FL 33193-2503
Phone (305) 510-8483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20120229000377 IL Practitioner - Nurse Practitioner 2264690866

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1769532FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1073644035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15270 SW 57TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331932503",
            "telephone_number": "305-510-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042101",
            "telephone_number": "309-665-4729",
            "fax_number": "309-665-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBERON-SONE",
        "first_name": "CECILIA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "1769532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.