Individual provider Active NPI

Stephan Kendal Gunter, L.P.N., C.N.A.

  • Licensed Practical Nurse
  • Syracuse, NY
National Provider Identifier
1710216627
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
298458 Issued in NY
Practice address
321 W Lafayette Ave
Syracuse, NY 13205-1661
Phone
(315) 299-5764
NPI assigned
Dec 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 298458 NY Primary
Nurse's Aide 376K00000X 342576930607E NY

Addresses

Primary practice location

321 W Lafayette Ave
Syracuse, NY 13205-1661

Mailing address

321 W Lafayette Ave
Syracuse, NY 13205-1661
Phone (315) 299-5764

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

State licenses

LicenseStateTypeSpecialty
342576930607ENYMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1710216627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W LAFAYETTE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132051661",
            "telephone_number": "315-299-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W LAFAYETTE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132051661",
            "telephone_number": "315-299-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "STEPHAN",
        "middle_name": "KENDAL",
        "name_prefix": "Mr.",
        "credential": "L.P.N., C.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "298458",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NY",
            "license": "342576930607E",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.