Kevin Richard Bellanger

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

254194 Issued in NY

Practice address

6021 Statefarm Rd
Guilderland, NY 12084

Phone

(518) 456-6525

NPI assigned

Aug 21, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1962659896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ALTAMONT RD",
            "city": "VOORHEESVILLE",
            "state": "NY",
            "postal_code": "121869637",
            "telephone_number": "518-765-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 STATEFARM RD",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "12084",
            "telephone_number": "518-456-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLANGER",
        "first_name": "KEVIN",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-21",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "254194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Christine Asvestas, LMHC
• Peter Mark Avery, PHARM D
• Julia Marie Ball, MSW, LCSW
• Michelle M Barnes
• Carol Jean Barr
• Amy Jo Bellomy
• Alexis Benedetti, LMHC
• Melissa Leah Blok, LMSW
• Laurie L Bortscheller
• Ashley Nicole Bowery, CASAC INTERN

• All providers in Guilderland, NY
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.