Anita Farry, FNP

Key facts

NPI

1124331228

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

F334137-1 (NY)

Practice address

19 Whipple Way
Altamont, NY 12009-9204

Phone

(518) 346-3100

Fax

(877) 583-1284

NPI assigned

Jul 17, 2010

Sex

Female

Sole proprietor

Yes

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.

• Donna Heffernan MD PLLC Family Medicine Physician · Troy, NY · NPI 1336898303
  NPD
• Kaitlin Kuwitzky PA PLLC Medical Physician Assistant · Malta, NY · NPI 1508678566
  NPD
• Jeffrey Gerson MD Gastroenterology Physician · Albany, NY · NPI 1447345731
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: afarry@landmarkhealth-direct.org

Specialties & licenses

Addresses

Other names

• Miss Anita Shackelford Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 16, 2022.

{
    "created_epoch": "1279324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1124331228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3203",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123030203",
            "telephone_number": "518-346-3100",
            "fax_number": "877-583-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WHIPPLE WAY",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120099204",
            "telephone_number": "518-346-3100",
            "fax_number": "877-583-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRY",
        "first_name": "ANITA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-17",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334137-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "SHACKELFORD",
            "prefix": "MISS",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altamont, NY

• Nicole Michelle Derry
• Yasir Alam Khan Durrani
• Adam Ames Edwards, D.D.S.
• Jessica Evans
• Family Health & Sports Chiropractic
• Stuart F Fass, D.D.S.
• Raymond Fertig, MD
• Catherine L Foley, LMFT
• Lorraine V Golan, RPH
• Carolyn R. Goldstein, LCSW-R

All providers in Altamont, NY · Family Nurse Practitioner in New York