Individual provider Active NPI

Cheryl Ann Draper, LPN

  • Licensed Practical Nurse
  • Bath, NY
National Provider Identifier
1083733976
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
158810-1 Issued in NY
Practice address
7172 County Route 13
Bath, NY 14810-7901
Phone
(607) 776-6501
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 158810-1 NY Primary

Addresses

Primary practice location

7172 County Route 13
Bath, NY 14810-7901

Mailing address

7172 County Route 13
P.O. Box 814
Bath, NY 14810-7901
Phone (607) 776-6501

Other identifiers 2

IdentifierTypeStateIssuer
01196038MedicaidNY
158810-1OtherNYNYS NURSING LICENCE NUMER

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
158810-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083733976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7172 COUNTY ROUTE 13",
            "address_2": "P.O. BOX 814",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148107901",
            "telephone_number": "607-776-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7172 COUNTY ROUTE 13",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148107901",
            "telephone_number": "607-776-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAPER",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "158810-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01196038",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS NURSING LICENCE NUMER",
            "identifier": "158810-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.