Individual provider Active NPI

William Stines, LPN

  • Licensed Practical Nurse
  • West Plains, MO
National Provider Identifier
1053789933
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2010002710 Issued in MO
Practice address
1639 Bruce Smith Pkwy
West Plains, MO 65775-7691
Phone
(417) 257-1833
Fax
(417) 256-0488
NPI assigned
Sep 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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 2010002710 MO Primary

Addresses

Primary practice location

1639 Bruce Smith Pkwy
West Plains, MO 65775-7691

Mailing address

1639 Bruce Smith Pkwy
West Plains, MO 65775-7691
Phone (417) 257-1833

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
2010002710MOMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
BHG Xxviii, LLC PastSince Oct 1, 2015 Accepting new patients
BHG Lxxiv, LLC PastSince Dec 13, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1053789933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 BRUCE SMITH PKWY",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657757691",
            "telephone_number": "417-257-1833",
            "fax_number": "417-256-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 BRUCE SMITH PKWY",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657757691",
            "telephone_number": "417-257-1833",
            "fax_number": "417-256-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINES",
        "first_name": "WILLIAM",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2010002710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.