NPIMap

Organization Active NPI

Mobile Nurse Practitioners

  • Gerontology Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1740219633
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F340101 Issued in NY
Legal business name
MOBILE NURSE PRACTITIONERS
Practice address
5574 Main St
Williamsville, NY 14221-5452
Phone
(716) 634-2671
Fax
(716) 634-2673
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Donna Keith-McCain, ANP,GNP
Title
President
Phone
(716) 634-2671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X F340101 NY Primary

Addresses

Primary practice location

5574 Main St
Williamsville, NY 14221-5452

Mailing address

1102 Netherton CT
East Amherst, NY 14051-2454
Phone (716) 634-2671

Other identifiers 2

IdentifierTypeStateIssuer
F340101OtherNYLICENSE
01816128MedicaidNY

Other names 1

  • HOMELINK MEDICAL SERVICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Homelink Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5574 Main St
Williamsville, NY 14221
Phone (716) 634-2671

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740219633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 NETHERTON CT",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512454",
            "telephone_number": "716-634-2671",
            "fax_number": "716-634-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5574 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215452",
            "telephone_number": "716-634-2671",
            "fax_number": "716-634-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE NURSE PRACTITIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEITH-MCCAIN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-634-2671",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ANP,GNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "F340101",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01816128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOMELINK MEDICAL SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.