Active NPI
Elizabeth Ann Roberts, RNBSN
- Registered Nurse
- Syracuse, NY
National Provider Identifier
1457629628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 354368-1
- Practice address
- 108 Shonnard St
Syracuse, NY 13204-3216 - Phone
- (315) 435-4973
- Fax
- (315) 435-4934
- NPI assigned
- Dec 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 354368-1 | NY | Primary |
Addresses
Primary practice location
108 Shonnard St
Syracuse, NY 13204-3216
Mailing address
5341 Strawflower Dr
N Syracuse, NY 13212-1242
Phone (315) 435-4973
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 |
|---|---|---|---|
| 354368-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322784000000",
"number": "1457629628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5341 STRAWFLOWER DR",
"city": "N SYRACUSE",
"state": "NY",
"postal_code": "132121242",
"telephone_number": "315-435-4973",
"fax_number": "315-435-4934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 SHONNARD ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132043216",
"telephone_number": "315-435-4973",
"fax_number": "315-435-4934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "RNBSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-02",
"last_updated": "2011-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "354368-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.