Katie Larissa Lupton

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043106608 Issued in IL

Practice address

1249 Omega Circle Dr
Dekalb, IL 60115-5809

Phone

(815) 501-3121

NPI assigned

Oct 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katie Larissa Conboy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1033871744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 OMEGA CIRCLE DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601155809",
            "telephone_number": "815-501-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 OMEGA CIRCLE DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601155809",
            "telephone_number": "815-501-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPTON",
        "first_name": "KATIE",
        "middle_name": "LARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-10",
        "last_updated": "2021-10-10",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043106608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "CONBOY",
            "middle_name": "LARISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Ka Loo
• Emily A Lowe
• Cecilia Lucente
• Katherine Morge Lueken, LCSW
• Clarissa Amanda Luke
• Judith Lutz
• Abby Lynch
• Coresair Anton Mack
• Lorna K. Mackeben, RN,CNP
• Lauren Mackey, LPC

• Licensed Practical Nurse in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; 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.