Individual provider Active NPI

Mary E Hacker, RN

  • Health Maintenance Organization
  • Fairport, NY
National Provider Identifier
1881941748
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
251E00000X Issued in NY
Practice address
34 Little Spring Run
Fairport, NY 14450-3204
Phone
(585) 248-8723
NPI assigned
Aug 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 251E00000X NY Primary

Addresses

Primary practice location

34 Little Spring Run
Fairport, NY 14450-3204

Mailing address

34 Little Spring Run
Fairport, NY 14450-3204
Phone (585) 248-8723

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
251E00000XNYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1881941748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 LITTLE SPRING RUN",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503204",
            "telephone_number": "585-248-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 LITTLE SPRING RUN",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503204",
            "telephone_number": "585-248-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKER",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": "251E00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.