Active NPI
M. Kathleen Scanlon, PNP
- Pediatric Nurse Practitioner
- Watertown, NY
National Provider Identifier
1831186402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- F381157-1
- Practice address
- 35 Empsall Plaza
Watertown, NY 13601-0000 - Phone
- (315) 464-2027
- NPI assigned
- Sep 29, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | F381157-1 | NY | Primary |
Addresses
Primary practice location
35 Empsall Plaza
Watertown, NY 13601-0000
Mailing address
36 W 5TH St
Oswego, NY 13126-1315
Phone (315) 342-5469
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
| License | State | Type | Specialty |
|---|---|---|---|
| F381157-1 | NY | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1831186402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 W 5TH ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131261315",
"telephone_number": "315-342-5469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 EMPSALL PLAZA",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136010000",
"telephone_number": "315-464-2027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANLON",
"first_name": "M. KATHLEEN",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "F381157-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.