Aging With Vitality- Awv LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

AGING WITH VITALITY- AWV LLC

Practice address

19 Circle Dr
Pawling, NY 12564-1402

Phone

(914) 837-1997

NPI assigned

Mar 8, 2025

Last updated

Mar 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Sashanna Arvidson, AGNP- MSN, BCNPI 1043935620

Title

Nurse Practitioner

Phone

(914) 837-1997

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Sashanna Arvidson, AGNP- BC, MSN

  • Adult Health Nurse Practitioner
  • White Plains, NY
  • NPI 1043935620
  NPD Authorized official

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1114726635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CIRCLE DR",
            "city": "PAWLING",
            "state": "NY",
            "postal_code": "125641402",
            "telephone_number": "914-837-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CIRCLE DR",
            "city": "PAWLING",
            "state": "NY",
            "postal_code": "125641402",
            "telephone_number": "914-837-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGING WITH VITALITY- AWV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "ARVIDSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "SASHANNA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "914-837-1997",
        "authorized_official_credential": "AGNP- MSN, BC"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Pawling, NY
• Providers in Pawling, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; 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.