Individual provider Active NPI

Dallas Rae Hunt

  • Licensed Practical Nurse
  • Syracuse, NY
National Provider Identifier
1730975269
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
328673 Issued in NY
Practice address
1919 Valley Dr
Syracuse, NY 13207-2835
Phone
(315) 575-2040
NPI assigned
Apr 21, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 328673 NY Primary

Addresses

Primary practice location

1919 Valley Dr
Syracuse, NY 13207-2835

Mailing address

1919 Valley Dr
Syracuse, NY 13207-2835
Phone (315) 575-2040

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
328673NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1730975269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 VALLEY DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132072835",
            "telephone_number": "315-575-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 VALLEY DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132072835",
            "telephone_number": "315-575-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNT",
        "first_name": "DALLAS",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "328673",
            "primary": true
        }
    ],
    "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 Apr 21, 2025; 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.