Individual provider Active NPI

Janice Cecilia Forsberg

  • School Registered Nurse
  • Vestal, NY
National Provider Identifier
1770144511
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
297546-1 Issued in NY
Practice address
Clayton Avenue Elementary School
209 Clayton Avenue
Vestal, NY 13850
Phone
(607) 757-2274
Fax
(607) 757-2372
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 297546-1 NY Primary

Addresses

Primary practice location

Clayton Avenue Elementary School
209 Clayton Avenue
Vestal, NY 13850

Mailing address

Clayton Avenue Elementary School
209 Clayton Avenue
Vestal, NY 13850
Phone (607) 757-2274

Other identifiers 1

IdentifierTypeStateIssuer
6077489473MedicaidNY

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
297546-1NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1770144511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLAYTON AVENUE ELEMENTARY SCHOOL",
            "address_2": "209 CLAYTON AVENUE",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "13850",
            "telephone_number": "607-757-2274",
            "fax_number": "607-757-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLAYTON AVENUE ELEMENTARY SCHOOL",
            "address_2": "209 CLAYTON AVENUE",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "13850",
            "telephone_number": "607-757-2274",
            "fax_number": "607-757-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSBERG",
        "first_name": "JANICE",
        "middle_name": "CECILIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "297546-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6077489473",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.