Active NPI
Dorothy Marie Wilbur
- Registered Nurse
- Albany, NY
National Provider Identifier
1558554261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 373020-1
- Practice address
- 96 Waterman Ave
Albany, NY 12205-3628 - Phone
- (518) 456-2030
- NPI assigned
- Aug 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 373020-1 | NY | Primary |
Addresses
Primary practice location
96 Waterman Ave
Albany, NY 12205-3628
Mailing address
96 Waterman Ave
Albany, NY 12205-3628
Phone (518) 456-2030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02063252 | 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 |
|---|---|---|---|
| 373020-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188172800000",
"number": "1558554261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 WATERMAN AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122053628",
"telephone_number": "518-456-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 WATERMAN AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122053628",
"telephone_number": "518-456-2030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBUR",
"first_name": "DOROTHY",
"middle_name": "MARIE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-27",
"last_updated": "2007-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "373020-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02063252",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.