F. Diane Cloyd, RN

Key facts

NPI

1871789693

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

540358 (NY)

Practice address

280 Shanty Creek Rd
Central Square, NY 13036-3416

Phone

(315) 698-8690

NPI assigned

Sep 16, 2007

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 16, 2007.

{
    "created_epoch": "1189900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189900800000",
    "number": "1871789693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SHANTY CREEK RD",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130363416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SHANTY CREEK RD",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130363416",
            "telephone_number": "315-698-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOYD",
        "first_name": "F. DIANE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-16",
        "last_updated": "2007-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "540358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02631336",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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