Mrs. Anita Farry
Miss Anita Shackelford · Nurse Practitioner (Family)

Address: 112 Great Oaks Blvd, Albany, NY 12203-7924
Phone: 5188621332

Mrs. Anita Farry (NPI# 1124331228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1124331228
Entity Type Individual
Full Name Mrs. Anita Farry
Other Name Miss Anita Shackelford
Credential FNP
Gender Female
Practice Address 112 Great Oaks Blvd
Albany
NY 12203-7924
Practice Telephone 5188621332
Practice Fax Number 5188621399
Mailing Address 112 Great Oaks Blvd
Dr Gerson
Albany
NY 12203-7924
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2010-07-17
Last Update Date 2013-05-20

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LF0000X Nurse Practitioner · Family Physician Assistants & Advanced Practice Nursing Providers F334137-1 NY

Physician Overview

NPI 1124331228
PAC ID by PECOS 2062605587
Professional Enrollment ID I20101018000017
Full Name Anita S Farry
Organization Legal Name ALBANY-CAPITAL REGION GASTROENTEROLOGY CONSULTANTS CO PLLC
Phone Number 5184384483
Gender F
Graduation Year 2003
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 4789843228
Number of Group Practice Members 38
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
330057 ST PETER'S HOSPITAL
330003 ALBANY MEMORIAL HOSPITAL

Office Location

Street Address 112 GREAT OAKS BLVD
City ALBANY
State NY
Zip Code 12203-7924

Providers in the same location

NPI Name Taxonomy Address Enumeration
1447345731 Jeffrey Gerson Md Internal Medicine 112 Great Oaks Blvd, Albany, NY 12203-5953 2006-10-04
1902993405 Cathy A Cranker Nurse Practitioner 112 Great Oaks Blvd, Albany, NY 12203 2006-10-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205365640 Esther Pearl Jackson Counselor 41 North Allen St. - Pine Hills Elementary School, Albany, NY 12203 2017-06-08
1558899591 Diane Marie Wyatt Social Worker 1044 Western Ave, Albany, NY 12203 2017-06-02
1366980419 Lessie Lynette Johnson Social Worker 40 N. Main Ave, St. Catherine's Center for Children, Albany, NY 12203 2017-02-09
1588108617 Theresa Viola Dicroce Physical Therapy Assistant One Rapp Road, Advanced Therapy, P.l.l.c., Albany, NY 12203 2016-12-08
1366813818 Eileen Nancy Nagy Audiologist 14 Columbia Circle, Suite 202, Albany, NY 12203 2015-10-09
1609242197 Jaclyn Whitman Specialist 230 Washington Ave Extention, Albany, NY 12203 2015-08-19
1447657457 Joyce Yvette Dewitt-parker Psychologist 260 Washington Ave. Ext., Corporate Plaza, Suite 101, Albany, NY 12203 2014-11-20
1023357373 Meredith Gaucher Physical Therapist 1971 Western Ave Ste 100, Albany, NY 12203 2013-02-06
1598000655 St Peters Health Partners Medical Associates, PC Family Medicine 1444 Western Avenue, Suite C, St. Peter's Family Medicine, Albany, NY 12203 2012-11-30
1194079269 Mary D Eaton Specialist 1 Rapp Road, Advanced Therapy P.l.l.c., Albany, NY 12203 2012-10-29
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to comeā€¦

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NPI Name Taxonomy Address Enumeration
1528539970 Karmen Janelle Williams Nurse Practitioner 625 Cedar Ave, Albany, GA 31701-3477 2018-12-11
1679041107 Antonio Miller Nurse Practitioner 2027 W Broad Ave, Albany, GA 31707-4124 2018-11-02
1629550041 Karen A Bedell Nurse Practitioner 920 Lark Dr., Albany, NY 12207 2018-09-01
1578059150 Whittnye Barksdale Nurse Practitioner 2822 Nottingham Way Ste 4, Albany, GA 31707-7630 2018-07-06
1821584459 Heather Melissa Wells Nurse Practitioner 5410 Paulk Dr, Albany, GA 31721-7434 2018-07-06
1912424052 Keneyana Meshell Solomon Nurse Practitioner 425 W 3rd Ave Ste 105, Albany, GA 31701-1969 2017-08-29
1629592696 Leigh Rhodes Singletary Nurse Practitioner 2300 Dawson Rd Ste 101, Albany, GA 31707-2804 2017-08-01
1215450747 Michelle Frijas Nurse Practitioner 405 Kains Ave Ste 201, Albany, CA 94706-1270 2017-07-17
1225550957 Christopher George Solomon Nurse Practitioner 2336 Dawson Rd., Urgent Care Center At Phoebe Northwest, Albany, GA 31707 2017-07-14
1255879664 Hannah J Mulligan Nurse Practitioner 1365 Washington Ave Ste 201, Albany, NY 12206-1098 2017-02-06
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Competitor

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City ALBANY
Zip Code 12203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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