Individual provider Active NPI

Robert Daniel Sharpe, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York Mills, NY
National Provider Identifier
1467733550
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401417-1 Issued in NY
Practice address
587 Main St Ste 110a
New York Mills, NY 13417-1488
Phone
(315) 507-5811
Fax
(315) 507-5823
NPI assigned
Sep 1, 2011
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401417-1 NY Primary

Addresses

Primary practice location

587 Main St Ste 110a
New York Mills, NY 13417-1488

Mailing address

587 Main St Ste 110a
New York Mills, NY 13417-1488
Phone (315) 507-5811

Other identifiers 1

IdentifierTypeStateIssuer
1730610510MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120627000003 NY Practitioner - Nurse Practitioner 4981861184 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F401417-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Hartford Psychiatric Services PLLC CurrentSince Nov 19, 2012 Accepting new patients
Family Services of Chemung County, Inc. Psychiatric/Mental Health CurrentSince Apr 18, 2017 Accepting new patients

Locations

1019 E Water St
Elmira, NY 14901
Phone (607) 733-5696

310 Pennsylvania Ave
Elmira, NY 14904
Phone (607) 733-2820

238 Oriskany Blvd
Whitesboro, NY 13492
Phone (315) 768-7181

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1467733550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 MAIN ST STE 110A",
            "city": "NEW YORK MILLS",
            "state": "NY",
            "postal_code": "134171488",
            "telephone_number": "315-507-5811",
            "fax_number": "315-507-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 MAIN ST STE 110A",
            "city": "NEW YORK MILLS",
            "state": "NY",
            "postal_code": "134171488",
            "telephone_number": "315-507-5811",
            "fax_number": "315-507-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARPE",
        "first_name": "ROBERT",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401417-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730610510",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York Mills, NY

Sources for this page

Verify at the official NPI Registry.