Individual provider Active NPI

Courtney Polimeni

  • Specialist
  • Edmeston, NY
National Provider Identifier
1124456660
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
56 East St
Edmeston, NY 13335-2405
Phone
(607) 353-9891
NPI assigned
Oct 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

56 East St
Edmeston, NY 13335-2405

Mailing address

56 East St
Edmeston, NY 13335-2405
Phone (607) 353-9891

Other names 1

  • Courtney Wyman Former name

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1124456660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 EAST ST",
            "city": "EDMESTON",
            "state": "NY",
            "postal_code": "133352405",
            "telephone_number": "607-353-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 EAST ST",
            "city": "EDMESTON",
            "state": "NY",
            "postal_code": "133352405",
            "telephone_number": "607-353-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIMENI",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "WYMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edmeston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.