Kylie Mae Tavernia

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1225 State Route 122
Constable, NY 12926-3006

Phone

(518) 651-0487

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Citizen Advocates, Inc

  dba North Star Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  NPD
• Citizen Advocates, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Malone, NY
  • NPI 1477765733
  NPD (past)

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1558025775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FINNEY BLVD",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531067",
            "telephone_number": "518-483-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 STATE ROUTE 122",
            "city": "CONSTABLE",
            "state": "NY",
            "postal_code": "129263006",
            "telephone_number": "518-651-0487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 6th St",
            "address_purpose": "LOCATION",
            "city": "Malone",
            "state": "NY",
            "postal_code": "129531246",
            "country_code": "US",
            "telephone_number": "518-483-3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVERNIA",
        "first_name": "KYLIE",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry A Avery, RN
• Constable Volunteer Firemen Inc
• Terra Godin, DPT
• Elizabeth Ann McCormick, LPN
• Bonnie Mae Pickering, LPN
• Kathy Marie Vezina, RN
• Westville Volunteer Firemans Association Inc (Westville Fire Dept.)

• Case Manager/Care Coordinator in Constable, NY
• Providers in Constable, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.