Individual provider Active NPI

Sharon Wilson

  • Addiction (Substance Use Disorder) Registered Nurse
  • Airmont, NY
National Provider Identifier
1336769041
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
689953 Issued in NY
Practice address
100 Route 59
Airmont, NY 10901-4927
Phone
(845) 369-9701
Fax
(845) 369-9704
NPI assigned
Apr 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 689953 NY Primary

Addresses

Primary practice location

100 Route 59
Airmont, NY 10901-4927

Mailing address

100 Route 59 Ste 117
Airmont, NY 10901-4927
Phone (845) 369-9701

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
689953NYMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1336769041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59 STE 117",
            "city": "AIRMONT",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-369-9701",
            "fax_number": "845-369-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "city": "AIRMONT",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-369-9701",
            "fax_number": "845-369-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHARON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "689953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Airmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.