Individual provider Active NPI

Eileen Kay Sturtevant, LPN

  • Licensed Practical Nurse
  • Rome, NY
National Provider Identifier
1508102641
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
099132-1 Issued in NY
Practice address
130 Brookley Rd
Rome, NY 13441-4300
Phone
(315) 533-1150
Fax
(315) 533-1169
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 099132-1 NY Primary

Addresses

Primary practice location

130 Brookley Rd
Rome, NY 13441-4300

Mailing address

130 Brookley Rd
Rome, NY 13441-4300
Phone (315) 533-1150

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
099132-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Cerebral Palsy, Inc Past Accepting new patients
Upstate Cerebral Palsy, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1508102641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BROOKLEY RD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414300",
            "telephone_number": "315-533-1150",
            "fax_number": "315-533-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BROOKLEY RD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414300",
            "telephone_number": "315-533-1150",
            "fax_number": "315-533-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURTEVANT",
        "first_name": "EILEEN",
        "middle_name": "KAY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "099132-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

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

Verify at the official NPI Registry.