Individual provider Active NPI

Deborah Lu Amidon, R.N.

  • Registered Nurse
  • Syracuse, NY
National Provider Identifier
1992149462
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
7471744 Issued in NY
Practice address
345 Jamesville Ave
Syracuse, NY 13210-3211
Phone
(315) 435-4563
NPI assigned
Apr 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 7471744 NY Primary

Addresses

Primary practice location

345 Jamesville Ave
Syracuse, NY 13210-3211

Mailing address

345 Jamesville Ave
Syracuse, NY 13210-3211
Phone (315) 435-4563

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
7471744NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1992149462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 JAMESVILLE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103211",
            "telephone_number": "315-435-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 JAMESVILLE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103211",
            "telephone_number": "315-435-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIDON",
        "first_name": "DEBORAH",
        "middle_name": "LU",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "7471744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.