Individual provider Active NPI

Stormy Renee Collett

  • Registered Nurse
  • Russell, NY
National Provider Identifier
1477845121
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
640606 Issued in NY
Practice address
115 County Route 17
Russell, NY 13684-3154
Phone
(315) 562-2017
NPI assigned
May 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 640606 NY Primary

Addresses

Primary practice location

115 County Route 17
Russell, NY 13684-3154

Mailing address

115 County Route 17
Russell, NY 13684-3154
Phone (315) 562-2017

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
640606NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1477845121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 COUNTY ROUTE 17",
            "city": "RUSSELL",
            "state": "NY",
            "postal_code": "136843154",
            "telephone_number": "315-562-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COUNTY ROUTE 17",
            "city": "RUSSELL",
            "state": "NY",
            "postal_code": "136843154",
            "telephone_number": "315-562-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "STORMY",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "640606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.