Individual provider Active NPI

Amy Rae Giboo, R.N.

  • Local Education Agency (LEA)
  • Belfast, NY
National Provider Identifier
1861709933
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
672036 Issued in NY
Practice address
1 King St
Belfast, NY 14711-8682
Phone
(585) 365-2646
Fax
(585) 365-2648
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 266865-1 NY
Local Education Agency (LEA) 251300000X 672036 NY Primary

Addresses

Primary practice location

1 King St
Belfast, NY 14711-8682

Mailing address

1 King St
Belfast, NY 14711-8682
Phone (585) 365-2646

Other practice location 1

1681 Elton Rd
Franklinville, NY 14737-9554
Phone (716) 676-9880

Other identifiers 1

IdentifierTypeStateIssuer
01377191MedicaidNY

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

LicenseStateTypeSpecialty
266865-1NYMDLicensed Practical Nurse
672036NYMDLocal Education Agency (LEA)

Practice roles

OrganizationSpecialtyStatusNew patients
Belfast Central School Local Education Agency (Lea) Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1861709933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KING ST",
            "city": "BELFAST",
            "state": "NY",
            "postal_code": "147118682",
            "telephone_number": "585-365-2646",
            "fax_number": "585-365-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KING ST",
            "city": "BELFAST",
            "state": "NY",
            "postal_code": "147118682",
            "telephone_number": "585-365-2646",
            "fax_number": "585-365-2648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1681 Elton Rd",
            "address_purpose": "LOCATION",
            "city": "Franklinville",
            "state": "NY",
            "postal_code": "147379554",
            "country_code": "US",
            "telephone_number": "716-676-9880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBOO",
        "first_name": "AMY",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "266865-1",
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NY",
            "license": "672036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01377191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfast, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.