Individual provider Active NPI

Mary Ellen Orr, RN

  • School Registered Nurse
  • Penn Yan, NY
National Provider Identifier
1467037630
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
644726-1 Issued in NY
Practice address
1 School Dr
Penn Yan, NY 14527-1081
Phone
(315) 536-2331
Fax
(315) 279-1246
NPI assigned
Mar 10, 2021
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 644726-1 NY Primary

Addresses

Primary practice location

1 School Dr
Penn Yan, NY 14527-1081

Mailing address

2064 Townsend Rd
Penn Yan, NY 14527-8711

Other identifiers 1

IdentifierTypeStateIssuer
01388403MedicaidNY

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
644726-1NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1467037630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 TOWNSEND RD",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145278711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCHOOL DR",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271081",
            "telephone_number": "315-536-2331",
            "fax_number": "315-279-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORR",
        "first_name": "MARY ELLEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "644726-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01388403",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.