Lee A Tardino, MSN ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209-000751 Issued in IL

Practice address

4 Memorial Dr Ste 210
Alton, IL 62002

Phone

(618) 463-5905

Fax

(618) 463-5935

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2511/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Granite City Clinic Corp

  dba Granite City Anesthesia

  • Certified Registered Nurse Anesthetist
  • Granite City, IL
  • NPI 1003892464
  NPD (past)
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1023120797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026751",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "62002",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARDINO",
        "first_name": "LEE",
        "middle_name": "A",
        "credential": "MSN ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "148611",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-000751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laquita Tague
• Dawn Nicole Talbert, D.O.
• Joseph M Talsky, MD
• Ellen Marie Tanner, OTRL
• Jennifer Tapen
• Lori Michele Tassinari, OTR
• Steve Tavernier, BSW
• Christine M Taylor, M.D.
• Deanna Nicole Taylor, PHARM D
• Katie Taylor, BA

• Adult Health Nurse Practitioner in Alton, IL
• Providers in Alton, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.