Individual provider Active NPI

Patricia Sallie, R.N.

  • Registered Nurse
  • Canon City, CO
National Provider Identifier
1710379938
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.0165753 Issued in CO
Practice address
201 N 6TH St
Canon City, CO 81212-3303
Phone
(719) 276-7450
Fax
(719) 276-7451
NPI assigned
Feb 25, 2015
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 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 RN.0165753 CO Primary

Addresses

Primary practice location

201 N 6TH St
Canon City, CO 81212-3303

Mailing address

201 N 6TH St
Canon City, CO 81212-3303
Phone (719) 276-7450

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
RN.0165753COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Fremont Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1710379938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N 6TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123303",
            "telephone_number": "719-276-7450",
            "fax_number": "719-276-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N 6TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123303",
            "telephone_number": "719-276-7450",
            "fax_number": "719-276-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLIE",
        "first_name": "PATRICIA",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0165753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.