Individual provider Active NPI

Mary Ann Krebbeks, APRN,NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pittsford, NY
National Provider Identifier
1487724944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400708-1 Issued in NY
Practice address
40 Office Park Way
Pittsford, NY 14534-1738
Phone
(585) 329-9336
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 F400708-1 NY Primary

Addresses

Primary practice location

40 Office Park Way
Pittsford, NY 14534-1738

Mailing address

208 Shirewood Dr
Rochester, NY 14625-2135
Phone (585) 329-9336

Other identifiers 1

IdentifierTypeStateIssuer
F400708-1OtherNYNURSE PRACTIONER LICENSE

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
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F400708-1NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487724944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SHIREWOOD DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252135",
            "telephone_number": "585-329-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 OFFICE PARK WAY",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341738",
            "telephone_number": "585-329-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREBBEKS",
        "first_name": "MARY ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN,NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400708-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTIONER LICENSE",
            "identifier": "F400708-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.