Organization Active NPI

Innovative Care and Consulting, LLC

  • Adult Health Nurse Practitioner
  • North Tonawanda, NY
National Provider Identifier
1508332297
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
INNOVATIVE CARE AND CONSULTING, LLC
Practice address
3024 Niagara Falls Blvd Ste 116
North Tonawanda, NY 14120-1116
Phone
(716) 217-4321
Fax
(716) 219-2469
NPI assigned
Oct 19, 2018
Last updated
Jan 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Lisa M Davis Wheeler, NP
Title
Owner
Phone
(716) 217-4321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X Primary

Addresses

Primary practice location

3024 Niagara Falls Blvd Ste 116
North Tonawanda, NY 14120-1116

Mailing address

2 Running Brook Drive
2 Running Brook Drive
Lancaster, NY 14086
Phone (716) 864-6316

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1508332297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RUNNING BROOK DRIVE",
            "address_2": "2 RUNNING BROOK DRIVE",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "14086",
            "telephone_number": "716-864-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 NIAGARA FALLS BLVD STE 116",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201116",
            "telephone_number": "716-217-4321",
            "fax_number": "716-219-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE CARE AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-19",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS WHEELER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-217-4321",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.