Individual provider Active NPI

Daniel Edward Vannorman, LPN

  • Licensed Practical Nurse
  • Canandaigua, NY
National Provider Identifier
1366592644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2388781 Issued in NY
Practice address
5151 West Lake Rd
Canandaigua, NY 14424
Phone
(585) 396-1602
NPI assigned
Jan 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2388781 NY Primary

Addresses

Primary practice location

5151 West Lake Rd
Canandaigua, NY 14424

Mailing address

80 Parish St
Apt 501
Canandaigua, NY 14424
Phone (585) 750-4223

Other identifiers 1

IdentifierTypeStateIssuer
02096688MedicaidNY

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
2388781NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366592644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PARISH ST",
            "address_2": "APT 501",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "14424",
            "telephone_number": "585-750-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 WEST LAKE RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "14424",
            "telephone_number": "585-396-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNORMAN",
        "first_name": "DANIEL",
        "middle_name": "EDWARD",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2388781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02096688",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.