Individual provider Active NPI

Leona M Tilley

  • Licensed Practical Nurse
  • Festus, MO
National Provider Identifier
1215053673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
028266 Issued in MO
Practice address
227 E Main St
Festus, MO 63028-1952
Phone
(636) 931-2700
Fax
(636) 931-5304
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 028266 MO Primary

Addresses

Primary practice location

227 E Main St
Festus, MO 63028-1952

Mailing address

227 E Main St
Festus, MO 63028-1952
Phone (636) 931-2700

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
028266MOMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215053673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952",
            "telephone_number": "636-931-2700",
            "fax_number": "636-931-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952",
            "telephone_number": "636-931-2700",
            "fax_number": "636-931-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "LEONA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "028266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.