Individual provider Active NPI

Tatanisha Monique McClary, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1275095861
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
331855-1 Issued in NY
Practice address
57 Arbutus St Apt 2
Rochester, NY 14609-3501
Phone
(585) 201-4007
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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 331855-1 NY Primary

Addresses

Primary practice location

57 Arbutus St Apt 2
Rochester, NY 14609-3501

Mailing address

57 Arbutus St Apt 2
Rochester, NY 14609-3501
Phone (585) 201-4007

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
331855-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1275095861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 ARBUTUS ST APT 2",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093501",
            "telephone_number": "585-201-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 ARBUTUS ST APT 2",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093501",
            "telephone_number": "585-201-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLARY",
        "first_name": "TATANISHA",
        "middle_name": "MONIQUE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "331855-1",
            "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 Apr 2, 2019; 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.