Individual provider Active NPI

Tara Vickers, R.N.

  • Addiction (Substance Use Disorder) Registered Nurse
  • Niagara Falls, NY
National Provider Identifier
1982159828
Registry record updated Aug 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
553163-1 Issued in NY
Practice address
2470 Allen Ave
Niagara Falls, NY 14303-1908
Phone
(716) 580-3556
NPI assigned
Aug 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 553163-1 NY Primary

Addresses

Primary practice location

2470 Allen Ave
Niagara Falls, NY 14303-1908

Mailing address

131 Colden CT
Cheektowaga, NY 14225-5002
Phone (716) 580-3665

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
553163-1NYMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1982159828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COLDEN CT",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142255002",
            "telephone_number": "716-580-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 ALLEN AVE",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143031908",
            "telephone_number": "716-580-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "TARA",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-21",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "553163-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2016; 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.