Mary Shaller, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

300636 Issued in NY

Practice address

4102 Old Vestal Rd
Vestal, NY 13850-3531

Phone

(607) 798-5692

NPI assigned

Feb 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1245537844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 OLD VESTAL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 OLD VESTAL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503531",
            "telephone_number": "607-798-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLER",
        "first_name": "MARY",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "300636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie L Shager, PA
• Arun P. Shah, MD
• Ayyaz M Shah, DO
• Punita A Shah, LCSW
• Fnu Shailesh, MD
• Daniel Sheffer, ATC
• Muhammad Shehryar, MBBS
• Lyudmila Shelestovsky
• David Blake Shipp, LMSW
• Megan Shofkom

• Adult Health Nurse Practitioner in Vestal, NY
• Providers in Vestal, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.