Active NPI
Timothy Govenettio
- Registered Nurse
- Buffalo, NY
National Provider Identifier
1629361068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 578216
- Practice address
- 430 Niagara Street
Buffalo, NY 14201 - Phone
- (716) 856-2587
- Fax
- (716) 856-2608
- NPI assigned
- May 18, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 578216 | SC | Primary |
Addresses
Primary practice location
430 Niagara Street
Buffalo, NY 14201
Mailing address
430 Niagara Street
Buffalo, NY 14201
Phone (716) 856-2587
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 |
|---|---|---|---|
| 578216 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305676800000",
"number": "1629361068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 NIAGARA STREET",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14201",
"telephone_number": "716-856-2587",
"fax_number": "716-856-2608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 NIAGARA STREET",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14201",
"telephone_number": "716-856-2587",
"fax_number": "716-856-2608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOVENETTIO",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-18",
"last_updated": "2011-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "578216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.