Individual provider Active NPI

Virginia Graydon, RN

  • Registered Nurse
  • Ithaca, NY
National Provider Identifier
1164736286
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
452311 Issued in NY
Practice address
110 Ho Plaza
Gannett Health Services / Cornell University
Ithaca, NY 14853-3101
Phone
(607) 255-6106
Fax
(607) 254-3503
NPI assigned
Jul 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 452311 NY Primary

Addresses

Primary practice location

110 Ho Plaza
Gannett Health Services / Cornell University
Ithaca, NY 14853-3101

Mailing address

110 Ho Plaza
Gannett Health Services / Cornell University
Ithaca, NY 14853-3101
Phone (607) 255-6106

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
452311NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1164736286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HO PLAZA",
            "address_2": "GANNETT HEALTH SERVICES / CORNELL UNIVERSITY",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533101",
            "telephone_number": "607-255-6106",
            "fax_number": "607-254-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HO PLAZA",
            "address_2": "GANNETT HEALTH SERVICES / CORNELL UNIVERSITY",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533101",
            "telephone_number": "607-255-6106",
            "fax_number": "607-254-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYDON",
        "first_name": "VIRGINIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-30",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "452311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.