Individual provider Active NPI

Richard Tebbe, LPN

  • Licensed Practical Nurse
  • Tipp City, OH
National Provider Identifier
1073897245
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN141727 Issued in OH
Practice address
7600 South Newbury Rd.
Tipp City, OH 45371
Phone
(937) 474-5334
NPI assigned
Oct 5, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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 PN141727 OH Primary

Addresses

Primary practice location

7600 South Newbury Rd.
Tipp City, OH 45371

Mailing address

7600 South Newbury Rd.
Tipp City, OH 45371
Phone (937) 474-5334

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
PN141727OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1073897245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 SOUTH NEWBURY RD.",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "45371",
            "telephone_number": "937-474-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 SOUTH NEWBURY RD.",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "45371",
            "telephone_number": "937-474-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBBE",
        "first_name": "RICHARD",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN141727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipp City, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.