NPIMap

Organization Active NPI

Mobile Primary Care Family Nurse Practitioners, PLLC

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1669673349
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333122 Issued in NY
Legal business name
MOBILE PRIMARY CARE FAMILY NURSE PRACTITIONERS, PLLC
Practice address
640 Ellicott St
Suite 105
Buffalo, NY 14203-1245
Phone
(716) 893-1010
Fax
(716) 893-1002
NPI assigned
May 30, 2007
Last updated
May 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Authorized official

Name
Cory Shaffer, N.P.
Title
Director
Phone
(716) 893-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333122 NY Primary

Addresses

Primary practice location

640 Ellicott St
Suite 105
Buffalo, NY 14203-1245

Mailing address

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone (716) 893-1010

National Provider Directory

National Provider Directory

Locations

1560 Harlem Rd
Ste 3
Cheektowaga, NY 14206

1560 Harlem Rd
Ste 4
Cheektowaga, NY 14206

1776 Tremainsville Rd
Toledo, OH 43613
Phone (419) 214-0606

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1669673349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ELLICOTT ST",
            "address_2": "SUITE 105",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031245",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PRIMARY CARE FAMILY NURSE PRACTITIONERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "716-893-1010",
        "authorized_official_credential": "N.P."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333122",
            "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 9, 2022; 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.