Amy Sue Trivison, LPN LICENSE # 275747

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

275747 Issued in NY

Practice address

302 Charlane Parkway
North Syracuse, NY 13212-4211

Phone

(315) 402-4518

NPI assigned

May 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Amy Sue Savic Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1083350524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CHARLANE PARKWAY",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124211",
            "telephone_number": "315-402-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHARLANE PARKWAY",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124211",
            "telephone_number": "315-402-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVISON",
        "first_name": "AMY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LPN LICENSE # 275747",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2024-04-01",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "275747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07762027",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "SAVIC",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "LPN LICENSE # 275747",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Practical Nurse in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Licensed Practical Nurse in New York

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