Individual provider Active NPI

Virginia Clive, ANP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1801083043
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F301771 Issued in NY
Practice address
40 La Riviere Dr Ste 201
Buffalo, NY 14202-4036
Phone
(716) 893-1010
Fax
(716) 893-1002
NPI assigned
Oct 2, 2007
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F301771 NY Primary

Addresses

Primary practice location

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4036

Mailing address

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4036
Phone (716) 893-1010

Other practice location 1

220 Tower St
Waterville, NY 13480-1128
Phone (315) 841-4156

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
I20110427000117 NY Practitioner - Nurse Practitioner 3779768247 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F301771NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little Falls Hospital CurrentSince Nov 4, 2019 Accepting new patients
Little Falls Hospital CurrentSince Nov 4, 2019 Accepting new patients
Physician Mobile Medical Care PC PastSince Apr 1, 2025 Accepting new patients
Buffalo Ultrasound, Idtf Inc Past Accepting new patients
Menorah Campus Adult Home, Inc. Past Accepting new patients

Locations

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1801083043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024036",
            "telephone_number": "716-893-1010",
            "fax_number": "716-890-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024036",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Tower St",
            "address_purpose": "LOCATION",
            "city": "Waterville",
            "state": "NY",
            "postal_code": "134801128",
            "country_code": "US",
            "telephone_number": "315-841-4156",
            "fax_number": "315-841-8856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLIVE",
        "first_name": "VIRGINIA",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.