Individual provider Active NPI

Fnu N/a Vishal

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
National Provider Identifier
1205520079
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 Kings Hwy S Ste 2525
Rochester, NY 14617-5504
Phone
(058) 592-2400
NPI assigned
Jun 6, 2023
Reactivated
Dec 4, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

100 Kings Hwy S Ste 2525
Rochester, NY 14617-5504

Mailing address

Norton Im Residency Clinic
96 15TH Street.NW, Suit 111
Norton, VA 24273
Phone (276) 439-1872

Other practice location 1

Norton IM Residency Clinic
96 15th street.NW, Suit 111
Norton, VA 24273
Phone (276) 439-1872

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

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1205520079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTON IM RESIDENCY CLINIC",
            "address_2": "96 15TH STREET.NW, SUIT 111",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "24273",
            "telephone_number": "276-439-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S STE 2525",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "058-592-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Norton IM Residency Clinic",
            "address_2": "96 15th street.NW, Suit 111",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "24273",
            "country_code": "US",
            "telephone_number": "276-439-1872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISHAL",
        "first_name": "FNU",
        "middle_name": "N/A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2025-12-04",
        "certification_date": "2025-03-30",
        "deactivation_date": "2025-07-24",
        "reactivation_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.