Individual provider Active NPI

Antoinette Marie Lanoue, RN

  • School Registered Nurse
  • Averill Park, NY
National Provider Identifier
1326317926
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
3591951 Issued in NY
Practice address
333 Ny 351
Averill Park, NY 12018-9794
Phone
(518) 674-7103
Fax
(518) 674-7121
NPI assigned
Dec 28, 2011
Last updated
Dec 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 3591951 NY Primary

Addresses

Primary practice location

333 Ny 351
Averill Park, NY 12018-9794

Mailing address

146 Gettle Rd # 1
Averill Park, NY 12018-9794
Phone (518) 674-7068

Other identifiers 1

IdentifierTypeStateIssuer
01379024MedicaidNY

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
3591951NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Averill Park Central School District Past Accepting new patients
Averill Park School District Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1326317926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GETTLE RD # 1",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120189794",
            "telephone_number": "518-674-7068",
            "fax_number": "518-674-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NY 351",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120189794",
            "telephone_number": "518-674-7103",
            "fax_number": "518-674-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANOUE",
        "first_name": "ANTOINETTE",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "3591951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01379024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Averill Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.