Individual provider Active NPI

Amber Brown

  • Licensed Practical Nurse
  • Sandy Creek, NY
National Provider Identifier
1396043030
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
269283 Issued in NY
Practice address
2114 Lake St
Sandy Creek, NY 13145-2199
Phone
(315) 408-8412
NPI assigned
Mar 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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 269283 NY Primary

Addresses

Primary practice location

2114 Lake St
Sandy Creek, NY 13145-2199

Mailing address

2114 Lake St
Sandy Creek, NY 13145-2199
Phone (315) 408-8412

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

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1396043030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 LAKE ST",
            "city": "SANDY CREEK",
            "state": "NY",
            "postal_code": "131452199",
            "telephone_number": "315-408-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 LAKE ST",
            "city": "SANDY CREEK",
            "state": "NY",
            "postal_code": "131452199",
            "telephone_number": "315-408-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMBER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "269283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Creek, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.