Individual provider Active NPI

Susan Jane Lester, R.N., A.N.P.

  • Adult Health Nurse Practitioner
  • Wellsville, NY
National Provider Identifier
1962413955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
301264 Issued in NY
Practice address
4192A Bolivar Rd
Wellsville, NY 14895-9325
Phone
(585) 593-4400
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 301264 NY Primary

Addresses

Primary practice location

4192A Bolivar Rd
Wellsville, NY 14895-9325

Mailing address

128 Pine St
Wellsville, NY 14895-1433
Phone (585) 593-0485

Other identifiers 1

IdentifierTypeStateIssuer
01671672MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
301264NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962413955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PINE ST",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148951433",
            "telephone_number": "585-593-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4192A BOLIVAR RD",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148959325",
            "telephone_number": "585-593-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "R.N., A.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01671672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.