Active NPI
Sandra Jones Shutler, RN
- Registered Nurse
- Malone, NY
National Provider Identifier
1528178605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 168842-1
- Practice address
- 155 Finney Blvd
Malone, NY 12953 - Phone
- (518) 483-0109
- Fax
- (518) 483-0115
- NPI assigned
- Aug 30, 2006
- 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 | 168842-1 | NY | Primary |
Addresses
Primary practice location
155 Finney Blvd
Malone, NY 12953
Mailing address
5153 State Route 11
Burke, NY 12917
Phone (518) 483-5565
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
| License | State | Type | Specialty |
|---|---|---|---|
| 168842-1 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Cerebral Palsy Association of the North Country, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Community Health Center of the North Country
- Federally Qualified Health Center (FQHC)
- Canton, NY
- NPI 1467432765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528178605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5153 STATE ROUTE 11",
"city": "BURKE",
"state": "NY",
"postal_code": "12917",
"telephone_number": "518-483-5565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 FINNEY BLVD",
"city": "MALONE",
"state": "NY",
"postal_code": "12953",
"telephone_number": "518-483-0109",
"fax_number": "518-483-0115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUTLER",
"first_name": "SANDRA",
"middle_name": "JONES",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "168842-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malone, 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.