Mary C Radimer, R.N.

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

371722-1 Issued in NY

Practice address

1463 State Route 30
Tupper Lake, NY 12986-2312

Phone

(518) 359-2159

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497969612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 STATE ROUTE 30",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129862312",
            "telephone_number": "518-359-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 STATE ROUTE 30",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129862312",
            "telephone_number": "518-359-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADIMER",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "371722-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE DUTY NURSE",
            "identifier": "01284743",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa E Morin, FNP
• Annmarie Munn
• Jacob Nashett, PHARM D.
• Lisa M O' Connor, PA-C
• Mikayla O'Connor
• Susan Reandeau
• Rehab Resources
• Lori A Richardson, LMHC
• Rite Aid of New York Inc
• Deborah Roddy

• All providers in Tupper Lake, NY
• Home Health Registered Nurse in New York

• 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.