Individual provider Active NPI

Cheryl Yancey, RN

  • Registered Nurse
  • Mishawaka, IN
National Provider Identifier
1689063497
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
123456 Issued in IN
Practice address
4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1442
Phone
(574) 231-6800
NPI assigned
Jan 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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 123456 IN Primary

Addresses

Primary practice location

4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1442

Mailing address

4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1442

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
123456INMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1689063497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451442",
            "telephone_number": "574-231-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "CHERYL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "123456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.