NPIMap

Organization Active NPI

Wayne County Dept of Aging and Youth

  • In Home Supportive Care Agency
  • Lyons, NY
National Provider Identifier
1306103569
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
WAYNE COUNTY DEPT OF AGING AND YOUTH
Practice address
1519 Nye Rd Ste 300
Lyons, NY 14489-9115
Phone
(315) 946-5624
Fax
(315) 946-5649
NPI assigned
Apr 12, 2012
Organization subpart
Yes
Parent organization
WAYNE COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Ms. Penny W Shockley
Title
Director
Phone
(315) 946-5624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1519 Nye Rd Ste 300
Lyons, NY 14489-9115

Mailing address

1519 Nye Rd Ste 300
Lyons, NY 14489-9115
Phone (315) 946-5624

Other identifiers 1

IdentifierTypeStateIssuer
01295514MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Wayne County Public Health14 organizations share this tax ID, including this one
Part of
Wayne County Public Health

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1519 Nye Rd
Ste 300
Lyons, NY 14489
Phone (315) 946-5624

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1306103569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 NYE RD STE 300",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899115",
            "telephone_number": "315-946-5624",
            "fax_number": "315-946-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 NYE RD STE 300",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899115",
            "telephone_number": "315-946-5624",
            "fax_number": "315-946-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COUNTY DEPT OF AGING AND YOUTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE COUNTY",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-946-5624",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01295514",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.