Individual provider Active NPI

Donna M. Fladd, N.P.

  • Nurse Practitioner
  • Penn Yan, NY
National Provider Identifier
1730262056
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F400778 Issued in NY
Practice address
465 N Main St
JDK Center
Penn Yan, NY 14527-1069
Phone
(315) 531-2400
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F400778 NY Primary

Addresses

Primary practice location

465 N Main St
JDK Center
Penn Yan, NY 14527-1069

Mailing address

4701 Middle Rd
Rushville, NY 14544-9708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902001424 NY Practitioner - Nurse Practitioner 2668448408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of WayneGroup PAC ID 8921919994, 21 clinicians

Practice addresses (Care Compare)

1519 Nye Rd
Suite 100
Lyons, NY 14489-9112
Phone (315) 946-5722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F400778NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Wayne CurrentSince Apr 29, 2015 Accepting new patients
Soldiers & Sailors Memorial Hospital Past Accepting new patients

Locations

1519 Nye Rd
Ste 100
Lyons, NY 14489
Phone (315) 946-5722

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1730262056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 MIDDLE RD",
            "city": "RUSHVILLE",
            "state": "NY",
            "postal_code": "145449708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 N MAIN ST",
            "address_2": "JDK CENTER",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271069",
            "telephone_number": "315-531-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLADD",
        "first_name": "DONNA",
        "middle_name": "M.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F400778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

Verify at the official NPI Registry.