Individual provider Active NPI

Molly Vanderwerff, RN BSN

  • Registered Nurse
  • Auburn, NY
National Provider Identifier
1336971589
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
797464-01 Issued in NY
Practice address
144 Genesee St
Auburn, NY 13021-3503
Phone
(315) 253-8477
NPI assigned
Aug 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 797464-01 NY Primary

Addresses

Primary practice location

144 Genesee St
Auburn, NY 13021-3503

Mailing address

9 Koenig CT
Auburn, NY 13021-1306
Phone (315) 515-9581

Other names 1

  • Molly Dacy Former name

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
797464-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1336971589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 KOENIG CT",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211306",
            "telephone_number": "315-515-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 GENESEE ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213503",
            "telephone_number": "315-253-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWERFF",
        "first_name": "MOLLY",
        "name_prefix": "Mrs.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "797464-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "DACY",
            "credential": "RN BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.