Individual provider Active NPI

Indra Siwakoti, LPN

  • Licensed Practical Nurse
  • Syracuse, NY
National Provider Identifier
1639456080
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
308064-1 Issued in NY
Practice address
706 N McBride St # 3
Syracuse, NY 13203-1734
Phone
(315) 432-5636
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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 308064-1 NY Primary

Addresses

Primary practice location

706 N McBride St # 3
Syracuse, NY 13203-1734

Mailing address

706 N McBride St # 3
Syracuse, NY 13203-1734
Phone (315) 432-5636

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
308064-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1639456080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 N MCBRIDE ST # 3",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031734",
            "telephone_number": "315-432-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 N MCBRIDE ST # 3",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031734",
            "telephone_number": "315-432-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIWAKOTI",
        "first_name": "INDRA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "308064-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.