Active NPI
Supplemental Professional Resources, Inc.
- Home Health Agency
- Lockport, NY
National Provider Identifier
1972591311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 9969L001
- Legal business name
- SUPPLEMENTAL PROFESSIONAL RESOURCES, INC.
- Practice address
- 3976 Lockport Olcott Rd
Lockport, NY 14094-1133 - Phone
- (716) 433-7810
- Fax
- (716) 433-7811
- NPI assigned
- Oct 10, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donald L Kepner
- Title
- Chief Financial Officer
- Phone
- (716) 514-5527
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 9969L001 | NY | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 9969L001 | NY |
Addresses
Primary practice location
3976 Lockport Olcott Rd
Lockport, NY 14094-1133
Mailing address
3976 Lockport Olcott Rd
Lockport, NY 14094-1133
Phone (716) 433-7810
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01879616 | Medicaid | NY | |
| 8210096 | Other | NY | IHA BILLING # |
| 00011340201 | Other | NY | UNIVERA BILLING # |
| 000551258001 | Other | NY | BCBS BILLING # |
| 01779735 | Medicaid | NY |
Other names 1
- Niagara Home Care
National Provider Directory
National Provider DirectoryLocations
3976 Lockport Olcott Rd
Lockport, NY 14094
Phone (716) 433-7810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1972591311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3976 LOCKPORT OLCOTT RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140941133",
"telephone_number": "716-433-7810",
"fax_number": "716-433-7811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3976 LOCKPORT OLCOTT RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140941133",
"telephone_number": "716-433-7810",
"fax_number": "716-433-7811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPPLEMENTAL PROFESSIONAL RESOURCES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-10",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "KEPNER",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "716-514-5527",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NY",
"license": "9969L001",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NY",
"license": "9969L001",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01879616",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA BILLING #",
"identifier": "8210096",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA BILLING #",
"identifier": "00011340201",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BILLING #",
"identifier": "000551258001",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01779735",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Niagara Home Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.