Amanda Chaffee

Key facts

NPI

1215763578

Entity type

Individual (NPI type 1)

Primary specialty

School Registered Nurse 163WS0200X

License

720504-01 (NY)

Practice address

101 S Loder Ave
Endicott, NY 13760-4810

Phone

(607) 757-2156

NPI assigned

Sep 12, 2024

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 12, 2024.

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1215763578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S LODER AVE",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604810",
            "telephone_number": "607-757-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S LODER AVE",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604810",
            "telephone_number": "607-757-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFEE",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "720504-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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