Individual provider Active NPI

Lisa M Merchant, LPN

  • Licensed Practical Nurse
  • Deruyter, NY
National Provider Identifier
1902144173
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
284994-1 Issued in NY
Practice address
470 Lincklaen Rd
Deruyter, NY 13052
Phone
(315) 852-2050
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 284994-1 NY Primary

Addresses

Primary practice location

470 Lincklaen Rd
Deruyter, NY 13052

Mailing address

470 Lincklaen Road
Deruyter, NY 13052
Phone (315) 852-2050

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

State licenses

LicenseStateTypeSpecialty
284994-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1902144173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 LINCKLAEN ROAD",
            "city": "DERUYTER",
            "state": "NY",
            "postal_code": "13052",
            "telephone_number": "315-852-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 LINCKLAEN RD",
            "city": "DERUYTER",
            "state": "NY",
            "postal_code": "13052",
            "telephone_number": "315-852-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "284994-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deruyter, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.