Active NPI
Tamara Alicia Lesure
- Home Health Aide
- Olive Branch, MS
National Provider Identifier
1083272892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 6355 Nesting Dove
Olive Branch, MS 38654-4700 - Phone
- (662) 812-7685
- NPI assigned
- Jun 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 89655 | TN | |
| Home Health Aide | 374U00000X | TN | Primary |
Addresses
Primary practice location
6355 Nesting Dove
Olive Branch, MS 38654-4700
Mailing address
6355 Nesting Dove
Olive Branch, MS 38654-4700
Phone (662) 812-7685
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
| License | State | Type | Specialty |
|---|---|---|---|
| 89655 | TN | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1083272892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6355 NESTING DOVE",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386544700",
"telephone_number": "662-812-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6355 NESTING DOVE",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386544700",
"telephone_number": "662-812-7685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESURE",
"first_name": "TAMARA",
"middle_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "TN",
"license": "89655",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olive Branch, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.