Individual provider Active NPI

Susan Diane McAndrews, LPN

  • Licensed Practical Nurse
  • Groton, NY
National Provider Identifier
1407119449
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
089435-1 Issued in NY
Practice address
405 W Cortland St
Box 147
Groton, NY 13073-1011
Phone
(607) 898-5889
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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 089435-1 NY Primary

Addresses

Primary practice location

405 W Cortland St
Box 147
Groton, NY 13073-1011

Mailing address

405 W Cortland St
Box 147
Groton, NY 13073-1011
Phone (607) 898-5889

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
089435-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1407119449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W CORTLAND ST",
            "address_2": "BOX 147",
            "city": "GROTON",
            "state": "NY",
            "postal_code": "130731011",
            "telephone_number": "607-898-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W CORTLAND ST",
            "address_2": "BOX 147",
            "city": "GROTON",
            "state": "NY",
            "postal_code": "130731011",
            "telephone_number": "607-898-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCANDREWS",
        "first_name": "SUSAN",
        "middle_name": "DIANE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "089435-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.