Active NPI
Mary Beth Daignault, RN
- Registered Nurse
- Syracuse, NY
National Provider Identifier
1801118120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 430987-1
- Practice address
- 2105 W Genesee St
Syracuse, NY 13219-1698 - Phone
- (315) 468-3239
- Fax
- (315) 468-2917
- NPI assigned
- Mar 1, 2010
- Last updated
- Mar 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 430987-1 | NY | Primary |
Addresses
Primary practice location
2105 W Genesee St
Syracuse, NY 13219-1698
Mailing address
8828 Waterview Cir
Cicero, NY 13039-7871
Phone (315) 699-1570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430987-1 | Other | NY | RN LICENSE |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 430987-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1801118120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8828 WATERVIEW CIR",
"city": "CICERO",
"state": "NY",
"postal_code": "130397871",
"telephone_number": "315-699-1570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 W GENESEE ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132191698",
"telephone_number": "315-468-3239",
"fax_number": "315-468-2917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAIGNAULT",
"first_name": "MARY",
"middle_name": "BETH",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-01",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "430987-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "430987-1",
"state": "NY"
}
],
"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 Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.