Individual provider Active NPI

Sally Ann Witalis, RN

  • Registered Nurse
  • West Seneca, NY
National Provider Identifier
1508991266
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
3556461 Issued in NY
Practice address
1200 E and West Rd
West Seneca, NY 14224-3604
Phone
(585) 343-4474
Fax
(585) 343-6768
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3556461 NY Primary

Addresses

Primary practice location

1200 E and West Rd
West Seneca, NY 14224-3604

Mailing address

13260 Colonial Woodsdr
Alden, NY 14004
Phone (716) 937-7930

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
3556461NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508991266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13260 COLONIAL WOODSDR",
            "city": "ALDEN",
            "state": "NY",
            "postal_code": "14004",
            "telephone_number": "716-937-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E AND WEST RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243604",
            "telephone_number": "585-343-4474",
            "fax_number": "585-343-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITALIS",
        "first_name": "SALLY ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "3556461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • 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.