Active NPI
Pamela Proulx
- Diabetes Educator Registered Nurse
- Cooperstown, NY
National Provider Identifier
1396126934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 553188-1
- Practice address
- 1 Atwell Rd
Cooperstown, NY 13326-1301 - Phone
- (607) 547-3649
- Fax
- (607) 547-4648
- NPI assigned
- Jun 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 553188-1 | NY | Primary |
Addresses
Primary practice location
1 Atwell Rd
Cooperstown, NY 13326-1301
Mailing address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3649
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N/A | Other | NY | N/A |
| N/A | Other | N/A |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 553188-1 | NY | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1396126934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ATWELL RD",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133261301",
"telephone_number": "607-547-3649",
"fax_number": "607-547-4648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ATWELL RD",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133261301",
"telephone_number": "607-547-3649",
"fax_number": "607-547-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROULX",
"first_name": "PAMELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-09",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "NY",
"license": "553188-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "N/A",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "N/A",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cooperstown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.