Individual provider Active NPI

Pamela Sue Anglin, RN

  • Registered Nurse
  • Plattsburgh, NY
National Provider Identifier
1104178698
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
644811-1 Issued in NY
Practice address
56 Fort Brown Dr
Plattsburgh, NY 12903-4935
Phone
(413) 531-6752
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 644811-1 NY Primary

Addresses

Primary practice location

56 Fort Brown Dr
Plattsburgh, NY 12903-4935

Mailing address

56 Fort Brown Dr
Plattsburgh, NY 12903-4935
Phone (413) 531-6752

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
644811-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1104178698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FORT BROWN DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129034935",
            "telephone_number": "413-531-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FORT BROWN DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129034935",
            "telephone_number": "413-531-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLIN",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "644811-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.