Mary Kathleen Amidon

Primary specialty

Social WorkerTaxonomy code 104100000X

License

101323 Issued in NY

Practice address

17 Herkimer Rd Ofc Room310
Utica, NY 13502-2309

Phone

(315) 235-7712

NPI assigned

Oct 5, 2011

Last updated

Jul 29, 2024By the provider in NPPES

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 names 1

• Mary Kathleen Doyle 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": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1124302419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HERKIMER RD OFC ROOM310",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022309",
            "telephone_number": "315-235-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HERKIMER RD OFC ROOM310",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022309",
            "telephone_number": "315-235-7712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3272 W Seneca Tpke",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132159645",
            "country_code": "US",
            "telephone_number": "315-982-0421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIDON",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DOYLE",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia A Altieri
• Jose A Alvarado-Cortes, LPN
• Amanda Stewart Family Health Nurse Practitioner
• Sherelyn Ambord
• George Amendolare
• Noura Amin, MD
• Almedin Andelija, RPH
• Harold Lyle Anderson, LCSW
• Stephanie Anderson
• Tracy M Anderson

• Social Worker in Utica, NY
• Providers in Utica, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.