Individual provider Active NPI

Deborah Ann Stevens, LPN

  • Licensed Practical Nurse
  • Saranac Lake, NY
National Provider Identifier
1275807489
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
267032-1 Issued in NY
Practice address
157 Bloomingdale Ave Apt 3
Saranac Lake, NY 12983
Phone
(518) 891-2118
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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 267032-1 NY Primary

Addresses

Primary practice location

157 Bloomingdale Ave Apt 3
Saranac Lake, NY 12983

Mailing address

157 Bloomingdale Ave Apt 3
Saranac Lake, NY 12983-5129
Phone (518) 891-2118

Other identifiers 1

IdentifierTypeStateIssuer
900790629OtherNYTAXPAYER IDENTIFICATION NUMBER

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
267032-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1275807489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 BLOOMINGDALE AVE APT 3",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835129",
            "telephone_number": "518-891-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 BLOOMINGDALE AVE APT 3",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "12983",
            "telephone_number": "518-891-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "267032-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXPAYER IDENTIFICATION NUMBER",
            "identifier": "900790629",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saranac Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.