Kelly Lynn Stark, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

305069 Issued in NY

Practice address

1174 Starr Rd
Apt 11
Cortland, NY 13045-6809

Phone

(607) 229-2831

NPI assigned

Jun 27, 2012

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

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1023372893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 STARR RD",
            "address_2": "APT 11",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130456809",
            "telephone_number": "607-229-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 STARR RD",
            "address_2": "APT 11",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130456809",
            "telephone_number": "607-229-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Skoros Spiers, LMSW
• Mitchell Spindler, DPT
• St Joseph'S Dialysis
• Jacquelyn Rae Staggs
• Pamela Ann Stanton, RN
• Alexandra Starmer, LMHC
• State of New York Comptrollers Office
• Jason Stepkovitch, M.D.
• Joanna Sue Stergion
• Nancy Lee Sternfeld, M.D.

• Licensed Practical Nurse in Cortland, NY
• Providers in Cortland, 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 Jun 27, 2012; 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.