Individual provider Active NPI

Mary Ellen Holmes, RN

  • School Registered Nurse
  • Walden, NY
National Provider Identifier
1891066478
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
329707 Issued in NY
Practice address
180 Ulster Ave
Walden, NY 12586-1060
Phone
(845) 778-3028
Fax
(845) 778-3785
NPI assigned
Jan 13, 2012
Last updated
Jan 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 329707 NY Primary

Addresses

Primary practice location

180 Ulster Ave
Walden, NY 12586-1060

Mailing address

180 Ulster Ave
Walden, NY 12586-1060
Phone (845) 778-3028

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
329707NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1891066478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ULSTER AVE",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "125861060",
            "telephone_number": "845-778-3028",
            "fax_number": "845-778-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ULSTER AVE",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "125861060",
            "telephone_number": "845-778-3028",
            "fax_number": "845-778-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "329707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.