Individual provider Active NPI

Alesia Mary Boyd Vannorman Orlando, MSED

  • Specialist
  • Mount Morris, NY
National Provider Identifier
1497018642
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
689728961 Issued in NY
Practice address
5871 Groveland Station Rd
Mount Morris, NY 14510-9767
Phone
(585) 658-4023
Fax
(585) 658-4066
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

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
689728961NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston County Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 689728961 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

5871 Groveland Station Rd
Mount Morris, NY 14510-9767

Mailing address

5871 Groveland Station Rd
Mount Morris, NY 14510-9767
Phone (585) 658-4023

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2012.

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1497018642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5871 GROVELAND STATION RD",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145109767",
            "telephone_number": "585-658-4023",
            "fax_number": "585-658-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5871 GROVELAND STATION RD",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145109767",
            "telephone_number": "585-658-4023",
            "fax_number": "585-658-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD VANNORMAN ORLANDO",
        "first_name": "ALESIA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "689728961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Morris, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.

Verify at the official NPI Registry.