Sandra Douglass, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

333844 Issued in NY

Practice address

344 Stissing Mountain Rd
Pine Plains, NY 12567-5455

Phone

(845) 392-3983

NPI assigned

Jan 19, 2024

Last updated

Jan 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sandra Watson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1992566608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 STISSING MOUNTAIN RD",
            "city": "PINE PLAINS",
            "state": "NY",
            "postal_code": "125675455",
            "telephone_number": "845-392-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 STISSING MOUNTAIN RD",
            "city": "PINE PLAINS",
            "state": "NY",
            "postal_code": "125675455",
            "telephone_number": "845-392-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "SANDRA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "333844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WATSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Richard Briggs Caldwell, M.D.
• Teresa Ann Costakis, R.N.
• Brittany Lee Cruickshank, LCSW
• Gladys Mae Deane, LPN
• Diane Diasparra, MS ED
• Dr Frank M Volz, Jr. & Associates
• Amy M. Duncan, LMSW
• Nancy H Dupont, PH.D., L.P.
• Russell George Edman, D.M.D.
• Amy Foley-Maeder, OTR/L

• Licensed Practical Nurse in Pine Plains, NY
• Providers in Pine Plains, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.