Individual provider Active NPI

Jackie Kim Tryon, RN

  • Lactation Consultant (Registered Nurse)
  • Kansas City, MO
National Provider Identifier
1083920029
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
082544 Issued in MO
Practice address
9405 N Oak Trfy
Kansas City, MO 64155-2233
Phone
(816) 412-2900
Fax
(816) 412-2915
NPI assigned
Aug 27, 2010
Last updated
Sep 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 082544 MO Primary

Addresses

Primary practice location

9405 N Oak Trfy
Kansas City, MO 64155-2233

Mailing address

9405 N Oak Trfy
Kansas City, MO 64155-2233
Phone (816) 412-2900

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
082544MOMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1083920029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 N OAK TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552233",
            "telephone_number": "816-412-2900",
            "fax_number": "816-412-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 N OAK TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552233",
            "telephone_number": "816-412-2900",
            "fax_number": "816-412-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRYON",
        "first_name": "JACKIE",
        "middle_name": "KIM",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MO",
            "license": "082544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.