Stacy M Bertram, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

274466 Issued in NY

Practice address

300 Gramatan Ave
Apt G85
Mount Vernon, NY 10552-3245

Phone

(914) 437-1455

NPI assigned

Apr 27, 2016

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 Stacy M Lynch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1154776102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GRAMATAN AVE",
            "address_2": "APT G85",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523245",
            "telephone_number": "914-437-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GRAMATAN AVE",
            "address_2": "APT G85",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523245",
            "telephone_number": "914-437-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "STACY",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "274466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "LYNCH",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bent on Wellness, LLC
• Monica Bentley-Sharpe10
• Judith Berenson, MSW
• Carol Berlind, LCSW
• Beth L Bernstein, MD PHD
• Tasha Bess, SCHOOL PSYCHOLOGIST
• Betiku & Hernandez Physical Therapy PLLC
• Adefemi Ayodeji Betiku, DPT
• Felicia Natalie Beville, OCCUPATIONAL THERAPY
• Manzoor Bhatti, MD

• Licensed Practical Nurse in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.