Individual provider Active NPI

Christine Gravelle

  • Registered Nurse
  • Ballston Lake, NY
National Provider Identifier
1730457813
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
359348-1 Issued in NY
Practice address
5 Valley View CT
Ballston Lake, NY 12019-9343
Phone
(518) 877-8839
NPI assigned
Dec 5, 2011
Last updated
Dec 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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 359348-1 NY Primary

Addresses

Primary practice location

5 Valley View CT
Ballston Lake, NY 12019-9343

Mailing address

5 Valley View CT
Ballston Lake, NY 12019-9343
Phone (518) 877-8839

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
359348-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1730457813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 VALLEY VIEW CT",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120199343",
            "telephone_number": "518-877-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 VALLEY VIEW CT",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120199343",
            "telephone_number": "518-877-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELLE",
        "first_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "359348-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.