Individual provider Active NPI

Cassema Tyease Burton, LPN

  • Licensed Practical Nurse
  • Cleveland, OH
National Provider Identifier
1184934598
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN128384-M-IV Issued in OH
Practice address
4480 Granada Blvd Apt 15
Cleveland, OH 44128-6014
Phone
(216) 772-7679
Fax
(216) 772-7679
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 PN128384-M-IV OH Primary

Addresses

Primary practice location

4480 Granada Blvd Apt 15
Cleveland, OH 44128-6014

Mailing address

4480 Granada Blvd Apt 15
Cleveland, OH 44128-6014
Phone (216) 772-7679

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
PN128384-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1184934598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 GRANADA BLVD APT 15",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441286014",
            "telephone_number": "216-772-7679",
            "fax_number": "216-772-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 GRANADA BLVD APT 15",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441286014",
            "telephone_number": "216-772-7679",
            "fax_number": "216-772-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "CASSEMA",
        "middle_name": "TYEASE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN128384-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.