Anita Farry, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F334137-1 Issued in NY

Practice address

19 Whipple Way
Altamont, NY 12009-9204

Phone

(518) 346-3100

Fax

(877) 583-1284

NPI assigned

Jul 17, 2010

Last updated

May 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Anita Shackelford Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

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

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

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

{
    "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"
        }
    ]
}

• 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

• Family Nurse Practitioner in Altamont, NY
• Providers in Altamont, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.