Active NPI
Cheryl Lee Sample, M.ED. TVI
- Specialist
- Cheektowaga, NY
National Provider Identifier
1487917225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 12345
- Practice address
- 4635 Union Rd
Cheektowaga, NY 14225-1851 - Phone
- (716) 505-5700
- Fax
- (716) 633-9351
- NPI assigned
- Jun 18, 2012
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 12345 | NY | Primary |
Addresses
Primary practice location
4635 Union Rd
Cheektowaga, NY 14225-1851
Mailing address
4635 Union Rd
Cheektowaga, NY 14225-1851
Phone (716) 505-5700
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
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12345 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Wny | Past | Accepting new patients | |
| Aspire Wny | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Cheektowaga, NY
- NPI 1386905115
-
- Early Intervention Provider Agency
- Cheektowaga, NY
- NPI 1790031201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339977600000",
"number": "1487917225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4635 UNION RD",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251851",
"telephone_number": "716-505-5700",
"fax_number": "716-633-9351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4635 UNION RD",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251851",
"telephone_number": "716-505-5700",
"fax_number": "716-633-9351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE",
"first_name": "CHERYL",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "M.ED. TVI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2012-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "12345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheektowaga, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.