Individual provider Active NPI

Timberlyn M Flory

  • Licensed Practical Nurse
  • Watertown, NY
National Provider Identifier
1558274092
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
333296 Issued in NY
Practice address
Building II, 22567 Summit Dr Ste B, Watertown, Ny 1360
Watertown, NY 13601
Phone
(315) 786-6821
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 333296 NY Primary

Addresses

Primary practice location

Building II, 22567 Summit Dr Ste B, Watertown, Ny 1360
Watertown, NY 13601

Mailing address

831 County Route 62
Sandy Creek, NY 13145-2108
Phone (315) 804-7494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1558274092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 COUNTY ROUTE 62",
            "city": "SANDY CREEK",
            "state": "NY",
            "postal_code": "131452108",
            "telephone_number": "315-804-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING II, 22567 SUMMIT DR STE B, WATERTOWN, NY 1360",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-786-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORY",
        "first_name": "TIMBERLYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "333296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.