Active NPI
Audrey Clinton
- Registered Nurse
- Oxford, NY
National Provider Identifier
1487103156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 619223
- Practice address
- 12 Fort Hill Park
Oxford, NY 13830 - Phone
- (607) 843-7185
- Fax
- (607) 843-3241
- NPI assigned
- Sep 23, 2016
- Last updated
- Sep 23, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 619223 | NY | Primary |
Addresses
Primary practice location
12 Fort Hill Park
Oxford, NY 13830
Mailing address
PO Box 192
Oxford, NY 13830-0192
Phone (607) 843-7185
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10379597 | Medicaid | NY |
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 |
|---|---|---|---|
| 619223 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oxford Academy & Central School District | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Oxford, NY
- NPI 1073663894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1487103156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 192",
"city": "OXFORD",
"state": "NY",
"postal_code": "138300192",
"telephone_number": "607-843-7185",
"fax_number": "607-843-3241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 FORT HILL PARK",
"city": "OXFORD",
"state": "NY",
"postal_code": "13830",
"telephone_number": "607-843-7185",
"fax_number": "607-843-3241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINTON",
"first_name": "AUDREY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "619223",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10379597",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.