Individual provider Active NPI

Sherry Bockus

  • Licensed Practical Nurse
  • Ithaca, NY
National Provider Identifier
1184451635
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
237358 Issued in NY
Practice address
334 W State St
Ithaca, NY 14850-5432
Phone
(607) 273-5500
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 237358 NY Primary

Addresses

Primary practice location

334 W State St
Ithaca, NY 14850-5432

Mailing address

334 W State St
Ithaca, NY 14850-5432
Phone (607) 273-5500

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

State licenses

LicenseStateTypeSpecialty
237358NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1184451635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505432",
            "telephone_number": "607-273-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505432",
            "telephone_number": "607-273-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKUS",
        "first_name": "SHERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "237358",
            "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 Sep 18, 2024; 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.