Individual provider Active NPI

Kellie Suzanne Cline, LPN

  • Licensed Practical Nurse
  • Portsmouth, OH
National Provider Identifier
1003015546
Registry record updated Jul 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.107186 Issued in OH
Practice address
144 Rigrish Rd
Portsmouth, OH 45662-9066
Phone
(740) 776-0836
NPI assigned
Jul 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.107186 OH Primary

Addresses

Primary practice location

144 Rigrish Rd
Portsmouth, OH 45662-9066

Mailing address

144 Rigrish Rd
Portsmouth, OH 45662-9066
Phone (740) 776-0836

Other identifiers 1

IdentifierTypeStateIssuer
2294557MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
PN.107186OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1184371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184371200000",
    "number": "1003015546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 RIGRISH RD",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456629066",
            "telephone_number": "740-776-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 RIGRISH RD",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456629066",
            "telephone_number": "740-776-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "KELLIE",
        "middle_name": "SUZANNE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-14",
        "last_updated": "2007-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.107186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2294557",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; 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.