Individual provider Active NPI

Amanda Lee Cusano, LPN

  • Licensed Practical Nurse
  • Kingsville, OH
National Provider Identifier
1124359955
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN-102299 Issued in OH
Practice address
4603 State Route 193
Kingsville, OH 44048-9722
Phone
(440) 224-0866
NPI assigned
Jan 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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 PN-102299 OH Primary

Addresses

Primary practice location

4603 State Route 193
Kingsville, OH 44048-9722

Mailing address

4603 State Route 193
Kingsville, OH 44048-9722
Phone (440) 224-0866

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
PN-102299OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1124359955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4603 STATE ROUTE 193",
            "city": "KINGSVILLE",
            "state": "OH",
            "postal_code": "440489722",
            "telephone_number": "440-224-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 STATE ROUTE 193",
            "city": "KINGSVILLE",
            "state": "OH",
            "postal_code": "440489722",
            "telephone_number": "440-224-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSANO",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-102299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.