Johanna M. Flanigan, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

217157 Issued in NY

Practice address

146 Gettle Road
Averill Park, NY 12018

Phone

(518) 674-7020

Fax

(518) 674-7052

NPI assigned

Jan 4, 2012

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1124398474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GETTLE ROAD, ST. 1",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "12018",
            "telephone_number": "518-674-7050",
            "fax_number": "518-674-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 GETTLE ROAD",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "12018",
            "telephone_number": "518-674-7020",
            "fax_number": "518-674-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "JOHANNA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "217157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01379024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Daloia, M.S.
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• Dragonfly & Owl, LLC
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• Charlene Foster
• Geoffrey Raymond Gamache, DDS
• Brenda Loraine Gausby, LMHC
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• Evelynn Ginsburg, RPH

• Registered Nurse in Averill Park, NY
• Providers in Averill Park, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.