Individual provider Active NPI

Jane E Waddell Tiberio, RN

  • Registered Nurse
  • Ontario, NY
National Provider Identifier
1659670099
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
484843-1 Issued in NY
Practice address
7334 Slocum Rd
Ontario, NY 14519-9751
Phone
(315) 333-5459
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 484843-1 NY Primary

Addresses

Primary practice location

7334 Slocum Rd
Ontario, NY 14519-9751

Mailing address

7334 Slocum Rd
Ontario, NY 14519-9751
Phone (315) 333-5459

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
484843-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1659670099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7334 SLOCUM RD",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "145199751",
            "telephone_number": "315-333-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7334 SLOCUM RD",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "145199751",
            "telephone_number": "315-333-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL TIBERIO",
        "first_name": "JANE",
        "middle_name": "E",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "484843-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.