John Alan Attebury, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041-09665 Issued in IL

Practice address

2401 W Main St
Marion, IL 62959-1188

Phone

(618) 997-5311

Fax

(619) 997-8268

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1083239503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BRAMLET ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301871",
            "telephone_number": "618-841-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311",
            "fax_number": "619-997-8268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kayenta Health C enter",
            "address_2": "Hwy 160 miles post 394.3",
            "address_purpose": "LOCATION",
            "city": "Kayenta",
            "state": "AZ",
            "postal_code": "86033",
            "country_code": "US",
            "telephone_number": "928-697-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Bramlet St",
            "address_purpose": "LOCATION",
            "city": "Eldorado",
            "state": "IL",
            "postal_code": "629301871",
            "country_code": "US",
            "telephone_number": "618-841-1934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATTEBURY",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-09665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Marion, IL
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.