Individual provider Active NPI

Michelle Marie Williams-Verduzco, LPN

  • Licensed Practical Nurse
  • Albany, NY
National Provider Identifier
1306197041
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
307573-1 Issued in NY
Practice address
251 Washington Avenue Ext
Albany, NY 12205-5504
Phone
(518) 456-4466
NPI assigned
Sep 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 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 307573-1 NY Primary

Addresses

Primary practice location

251 Washington Avenue Ext
Albany, NY 12205-5504

Mailing address

251 Washington Avenue Ext
Albany, NY 12205-5504
Phone (518) 456-4466

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
307573-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Early Childhood Education Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1306197041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 WASHINGTON AVENUE EXT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055504",
            "telephone_number": "518-456-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 WASHINGTON AVENUE EXT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055504",
            "telephone_number": "518-456-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-VERDUZCO",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "307573-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.