Individual provider Active NPI

Cynthia Ann Nixon

  • Licensed Practical Nurse
  • Cayuga, NY
National Provider Identifier
1629268628
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
1895721 Issued in NY
Practice address
483 Backus Rd
Cayuga, NY 13034-2176
Phone
(315) 224-1219
NPI assigned
Jul 26, 2007
Last updated
Jul 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 1895721 NY Primary

Addresses

Primary practice location

483 Backus Rd
Cayuga, NY 13034-2176

Mailing address

483 Backus Rd
Cayuga, NY 13034-2176
Phone (315) 224-1219

Other identifiers 1

IdentifierTypeStateIssuer
01925960MedicaidNY

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

LicenseStateTypeSpecialty
1895721NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1629268628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 BACKUS RD",
            "city": "CAYUGA",
            "state": "NY",
            "postal_code": "130342176",
            "telephone_number": "315-224-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 BACKUS RD",
            "city": "CAYUGA",
            "state": "NY",
            "postal_code": "130342176",
            "telephone_number": "315-224-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIXON",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "1895721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01925960",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayuga, NY

Sources for this page

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