Individual provider Active NPI

Melissa Siple

  • Licensed Practical Nurse
  • Brockport, NY
National Provider Identifier
1083257380
Registry record updated Oct 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
336172 Issued in NY
Practice address
8221 W Ridge Rd
Brockport, NY 14420-1429
Phone
(585) 880-9866
NPI assigned
Oct 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2019

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 336172 NY Primary

Addresses

Primary practice location

8221 W Ridge Rd
Brockport, NY 14420-1429

Mailing address

8221 W Ridge Rd
Brockport, NY 14420-1429
Phone (585) 880-9866

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
336172NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1571529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571529600000",
    "number": "1083257380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 W RIDGE RD",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201429",
            "telephone_number": "585-880-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 W RIDGE RD",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201429",
            "telephone_number": "585-880-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPLE",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-20",
        "last_updated": "2019-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "336172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2019; 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.