Individual provider Active NPI

Stephanie Yonkers

  • Pediatric Nurse Practitioner
  • Ballston Lake, NY
National Provider Identifier
1962617191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
237003-1 Issued in NY
Practice address
318 Ruhle Rd. S.
Ballston Lake, NY 12019
Phone
(518) 899-4133
Fax
(518) 899-5764
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

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
Pediatric Nurse Practitioner 363LP0200X 237003-1 NY Primary

Addresses

Primary practice location

318 Ruhle Rd. S.
Ballston Lake, NY 12019

Mailing address

318 Ruhle Rd. S.
Ballston Lake, NY 12019
Phone (518) 899-4133

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

State licenses

LicenseStateTypeSpecialty
237003-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Mohawk Pediatric & Adolescent Medicine PastSince Sep 17, 2014 Accepting new patients
Hudson Mohawk Pediatrics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962617191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 RUHLE RD. S.",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "12019",
            "telephone_number": "518-899-4133",
            "fax_number": "518-899-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 RUHLE RD. S.",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "12019",
            "telephone_number": "518-899-4133",
            "fax_number": "518-899-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONKERS",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "237003-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, 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.