Individual provider Active NPI

Jeffrey Obrien

  • Family Nurse Practitioner
  • Auburn, NY
National Provider Identifier
1508317330
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338746 Issued in NY
Practice address
17 Lansing St
Auburn, NY 13021-1983
Phone
(315) 255-7075
NPI assigned
Oct 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 338746 NY Primary

Addresses

Primary practice location

17 Lansing St
Auburn, NY 13021-1983

Mailing address

17 Lansing St
Auburn Community Hospital
Auburn, NY 13021-9519

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
338746NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1508317330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "address_2": "AUBURN COMMUNITY HOSPITAL",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.