Individual provider Active NPI

Anne Mary Clerkin, RN

  • Registered Nurse
  • Whitney Point, NY
National Provider Identifier
1689854473
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
322280-1 Issued in NY
Practice address
20 Allen Dr
Whitney Point, NY 13862-1818
Phone
(607) 692-3680
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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 322280-1 NY Primary

Addresses

Primary practice location

20 Allen Dr
Whitney Point, NY 13862-1818

Mailing address

20 Allen Dr
Whitney Point, NY 13862-1818
Phone (607) 692-3680

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
322280-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1689854473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ALLEN DR",
            "city": "WHITNEY POINT",
            "state": "NY",
            "postal_code": "138621818",
            "telephone_number": "607-692-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ALLEN DR",
            "city": "WHITNEY POINT",
            "state": "NY",
            "postal_code": "138621818",
            "telephone_number": "607-692-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERKIN",
        "first_name": "ANNE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "322280-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitney Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.