Upstate Medical Center

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

UPSTATE MEDICAL CENTER

Practice address

750 E Adams St
Syracuse, NY 13210-2342

Phone

(315) 464-5654

NPI assigned

Feb 9, 2011

Organization subpart

No

Name

Mr. Kevin Immarri Hickman, CRNA

Title

Nurse Anesthetist

Phone

(917) 579-8187

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 9, 2011.

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1386940252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7I CREEKSIDE VLG",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142610040",
            "telephone_number": "917-579-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "IMMARRI",
        "authorized_official_title_or_position": "NURSE ANESTHETIST",
        "authorized_official_telephone_number": "917-579-8187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upstate Community Medical, PC
• Upstate Emergency Medicine, Inc
• Upstate Family and Preventive Medicine, Inc
• Upstate Gastroenterology, LLC
• Upstate Medical Anesthesiology Group, Inc.
• Upstate Medical Professionals, PC
• Upstate Medical University
• Upstate Medical University
• Upstate Medical University
• Upstate Neurosurgery LLP

• All providers in Syracuse, NY
• General Acute Care Hospital in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.