Karen M Pellicore, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F335760-1 Issued in NY

Practice address

2816 Pleasant Ave
Lake View, NY 14085-9624

Phone

(716) 646-5500

Fax

(716) 646-5502

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Champlain Valley Internal Medicine

  • Internal Medicine Physician
  • Saint Albans, VT
  • NPI 1407999345
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1366498511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 PLEASANT AVE",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859624",
            "telephone_number": "716-646-5500",
            "fax_number": "716-646-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 PLEASANT AVE",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859624",
            "telephone_number": "716-646-5500",
            "fax_number": "716-646-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICORE",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "1010027182",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005182",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335760-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012039",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Theresa McGuire, LICENSED PRACTICAL N
• Justine Marie McQuillen, MS OTR/L
• Alycia N Meek
• Julie Moore, M.S. ED., CCC/SLP
• Stacey Morrisey, MA
• Amy Lynn Peterson
• Molly Caroline Pienta
• Lisa Marie Pirone, MS
• Mary A. Radens, RN
• Erson Paul Religioso III, DPT

• Family Nurse Practitioner in Lake View, NY
• Providers in Lake View, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.