Individual provider Active NPI

Ashley Albertin

  • Licensed Practical Nurse
  • Brewerton, NY
National Provider Identifier
1205345121
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
329931 Issued in NY
Practice address
10150 Black Creek Rd
Brewerton, NY 13029-9755
Phone
(315) 641-9587
NPI assigned
Sep 22, 2017
Last updated
Dec 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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 329931 NY Primary

Addresses

Primary practice location

10150 Black Creek Rd
Brewerton, NY 13029-9755

Mailing address

10150 Black Creek Rd
Brewerton, NY 13029-9755

Other names 1

  • Ashley Minter 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

State licenses

LicenseStateTypeSpecialty
329931NYMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1205345121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 BLACK CREEK RD",
            "city": "BREWERTON",
            "state": "NY",
            "postal_code": "130299755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 BLACK CREEK RD",
            "city": "BREWERTON",
            "state": "NY",
            "postal_code": "130299755",
            "telephone_number": "315-641-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERTIN",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "329931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MINTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brewerton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.