Individual provider Active NPI

Aimee C Vida, FNP

  • Family Nurse Practitioner
  • Akwesasne, NY
National Provider Identifier
1619995750
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334589 Issued in NY
Practice address
412 State Route 37
Akwesasne, NY 13655-3109
Phone
(518) 358-3141
NPI assigned
Jul 17, 2006
Last updated
Mar 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F334589 NY Primary

Addresses

Primary practice location

412 State Route 37
Akwesasne, NY 13655-3109

Mailing address

412 State Route 37
Akwesasne, NY 13655-3109
Phone (518) 358-3141

Other identifiers 1

IdentifierTypeStateIssuer
03127337MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F334589NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1619995750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "AKWESASNE",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "AKWESASNE",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDA",
        "first_name": "AIMEE",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03127337",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akwesasne, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.