Sara Renee Scully, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

724776 Issued in NY

Practice address

11 Denkers Dr
Ballston Lake, NY 12019-2228

Phone

(151) 825-8874

NPI assigned

Oct 18, 2022

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1871219220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DENKERS DR",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192228",
            "telephone_number": "151-825-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DENKERS DR",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192228",
            "telephone_number": "151-825-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "SARA",
        "middle_name": "RENEE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "724776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE, RN",
            "identifier": "724776",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Rae Ryan, PHARM.D
• Mary Jo Salomon
• Saratoga Hospital
• Saratoga Hospital
• Scotia Glenville Family Medicine, P.C.
• Natalia Selyuzhitski, PHARMD
• Margaret Peck Smith, M.S., C.C.C.-SLP
• Patricia A Southworth, RPH
• Thomas Joseph Stack, DDS
• Theresa M Steepe

• Registered Nurse in Ballston Lake, NY
• Providers in Ballston Lake, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.