Individual provider Active NPI

Todd Baker Fraley, R.N.

  • Registered Nurse
  • Syracuse, NY
National Provider Identifier
1528265683
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
548445-1 Issued in NY
Practice address
753 James St
829
Syracuse, NY 13203-2108
Phone
(315) 214-5005
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
Yes

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 548445-1 NY Primary

Addresses

Primary practice location

753 James St
829
Syracuse, NY 13203-2108

Mailing address

753 James St
829
Syracuse, NY 13203-2108
Phone (315) 214-5005

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
548445-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528265683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 JAMES ST",
            "address_2": "829",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032108",
            "telephone_number": "315-214-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 JAMES ST",
            "address_2": "829",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032108",
            "telephone_number": "315-214-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "TODD",
        "middle_name": "BAKER",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "548445-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, 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.