Active NPI
Amy Lynn O'Brien
- Registered Nurse
- Clinton, NY
National Provider Identifier
1518210566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 589985-1
- Practice address
- 7207 Dugway Rd
Clinton, NY 13323-4605 - Phone
- (315) 790-8022
- NPI assigned
- Oct 16, 2012
- Last updated
- Oct 16, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 589985-1 | NY | Primary |
Addresses
Primary practice location
7207 Dugway Rd
Clinton, NY 13323-4605
Mailing address
7207 Dugway Rd
Clinton, NY 13323-4605
Phone (315) 790-8022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163WS0200X | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 589985-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1518210566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7207 DUGWAY RD",
"city": "CLINTON",
"state": "NY",
"postal_code": "133234605",
"telephone_number": "315-790-8022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7207 DUGWAY RD",
"city": "CLINTON",
"state": "NY",
"postal_code": "133234605",
"telephone_number": "315-790-8022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "AMY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-16",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "589985-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163WS0200X",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.