Cynthia E Cavanaugh, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

296622 1 Issued in NY

Practice address

2968 Gulf Rd
Manlius, NY 13104

Phone

(315) 655-2597

NPI assigned

Sep 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Cynthia E Charles Other name

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": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1154517019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 GULF RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "13104",
            "telephone_number": "315-655-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 GULF RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "13104",
            "telephone_number": "315-655-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "CYNTHIA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "296622 1",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "296622 1",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "296622 1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02640393",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "CHARLES",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Debra A Buchan, MD
• C. J. Haslam Behavioral Health
• Danielle Elizabeth Cahill, PHARM.D.
• Christine Patrice Caldwell-Rudolph, LPN
• Jeffrey A Carmen, PH. D.
• Grace Cesarini, MA, RD, CHES
• Brian Yishing Changlai, MD
• Ronald Chapman, PT, GCS, CERT. MDT
• Aqib Javed Chowdhury
• David John Cifonelli, PT, DPT

• All providers in Manlius, NY
• Home Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.