Individual provider Active NPI

Tammy Lee Wiggins, LPN

  • Licensed Practical Nurse
  • Syracuse, NY
National Provider Identifier
1265665889
Registry record updated Aug 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
10293074 Issued in NY
Practice address
119 Thurlow Dr
Syracuse, NY 13205-2826
Phone
(315) 510-6968
NPI assigned
Aug 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2009

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 10293074 NY Primary

Addresses

Primary practice location

119 Thurlow Dr
Syracuse, NY 13205-2826

Mailing address

119 Thurlow Dr
Syracuse, NY 13205-2826
Phone (315) 510-6968

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
10293074NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1251590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251590400000",
    "number": "1265665889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 THURLOW DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052826",
            "telephone_number": "315-510-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 THURLOW DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052826",
            "telephone_number": "315-510-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "TAMMY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-30",
        "last_updated": "2009-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10293074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2009; 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.