Active NPI
Theresa D Dyer, LPN
- Licensed Practical Nurse
- Corning, OH
National Provider Identifier
1013203678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN.115355-MEDS
- Practice address
- 11482 Main St SE
Corning, OH 43730-9706 - Phone
- (740) 347-4583
- NPI assigned
- Jun 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN.115355-MEDS | OH | Primary |
Addresses
Primary practice location
11482 Main St SE
Corning, OH 43730-9706
Mailing address
11482 Main St SE
PO Box 77
Corning, OH 43730-9706
Phone (740) 347-4583
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
| License | State | Type | Specialty |
|---|---|---|---|
| PN.115355-MEDS | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1013203678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11482 MAIN ST SE",
"address_2": "PO BOX 77",
"city": "CORNING",
"state": "OH",
"postal_code": "437309706",
"telephone_number": "740-347-4583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11482 MAIN ST SE",
"city": "CORNING",
"state": "OH",
"postal_code": "437309706",
"telephone_number": "740-347-4583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "THERESA",
"middle_name": "D",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN.115355-MEDS",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corning, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.