Individual provider Active NPI

Kathryn Scott-Hlavac, FNP

  • Family Nurse Practitioner
  • Binghamton, NY
National Provider Identifier
1124222005
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333809 Issued in NY
Practice address
4400 Vestal Pkwy
Binghamton, NY 13902-4600
Phone
(607) 777-2221
Fax
(607) 777-2881
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 473936 NY
Family Nurse Practitioner 363LF0000X 333809 NY Primary

Addresses

Primary practice location

4400 Vestal Pkwy
Binghamton, NY 13902-4600

Mailing address

4400 Vestal Pkwy
Binghamton, NY 13902-4600
Phone (607) 777-2221

Other identifiers 1

IdentifierTypeStateIssuer
02281698MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
473936NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Binghamton University Health Services Past Accepting new patients
Ramanujapuram Ramanujan M.D. Past Accepting new patients
Binghamton University PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1124222005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 VESTAL PKWY",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139024600",
            "telephone_number": "607-777-2221",
            "fax_number": "607-777-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 VESTAL PKWY",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139024600",
            "telephone_number": "607-777-2221",
            "fax_number": "607-777-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT-HLAVAC",
        "first_name": "KATHRYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "473936",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02281698",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.