Individual provider Active NPI

Jill A Myers, NP

  • Family Nurse Practitioner
  • Vernon, NY
National Provider Identifier
1215988134
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331588 Issued in NY
Practice address
4857 State Route 5
Vernon, NY 13476-3530
Phone
(315) 363-9995
Fax
(315) 363-9686
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F331588 NY Primary

Addresses

Primary practice location

4857 State Route 5
Vernon, NY 13476-3530

Mailing address

4857 State Route 5
Vernon, NY 13476-3530
Phone (315) 363-9995

Other identifiers 1

IdentifierTypeStateIssuer
F331588OtherNYLICENSE

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
331588NYMDHematology & Oncology Physician
F331588NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cap Medical Group PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1215988134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4857 STATE ROUTE 5",
            "city": "VERNON",
            "state": "NY",
            "postal_code": "134763530",
            "telephone_number": "315-363-9995",
            "fax_number": "315-363-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4857 STATE ROUTE 5",
            "city": "VERNON",
            "state": "NY",
            "postal_code": "134763530",
            "telephone_number": "315-363-9995",
            "fax_number": "315-363-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JILL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "F331588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.