Individual provider Active NPI

Lori Ann Sobotka, RN

  • Registered Nurse
  • Liverpool, NY
National Provider Identifier
1679805329
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
593388-1 Issued in NY
Practice address
526 Old Liverpool Rd Ste 9
Liverpool, NY 13088-6285
Phone
(315) 453-3911
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 22593388 NY
Registered Nurse 163W00000X 593388-1 NY Primary

Addresses

Primary practice location

526 Old Liverpool Rd Ste 9
Liverpool, NY 13088-6285

Mailing address

406 Pleasant Ave
North Syracuse, NY 13212-3754
Phone (315) 378-5522

Other practice location 1

491 Clayton Manor Dr S
Apt. 5
Liverpool, NY 13088-3329
Phone (315) 383-2071

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
22593388NYMDRegistered Nurse
593388-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1679805329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 PLEASANT AVE",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123754",
            "telephone_number": "315-378-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 OLD LIVERPOOL RD STE 9",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130886285",
            "telephone_number": "315-453-3911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "491 Clayton Manor Dr S",
            "address_2": "Apt. 5",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130883329",
            "country_code": "US",
            "telephone_number": "315-383-2071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOBOTKA",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22593388",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "593388-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.