Active NPI
Laura A Dillard, LPN
- Licensed Practical Nurse
- Brunswick, OH
National Provider Identifier
1194867523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN100648
- Practice address
- 3229 Pinecrest Dr
Brunswick, OH 44212-3833 - Phone
- (440) 391-4751
- NPI assigned
- Feb 13, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN100648 | OH | Primary |
Addresses
Primary practice location
3229 Pinecrest Dr
Brunswick, OH 44212-3833
Mailing address
3229 Pinecrest Dr
Brunswick, OH 44212-3833
Phone (440) 391-4751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2610384 | Medicaid | OH |
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 |
|---|---|---|---|
| PN100648 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1194867523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3229 PINECREST DR",
"city": "BRUNSWICK",
"state": "OH",
"postal_code": "442123833",
"telephone_number": "440-391-4751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3229 PINECREST DR",
"city": "BRUNSWICK",
"state": "OH",
"postal_code": "442123833",
"telephone_number": "440-391-4751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "LAURA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN100648",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2610384",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.