Individual provider Active NPI

Cynthia Michelle Stark, LPN

  • Licensed Practical Nurse
  • Napoleon, OH
National Provider Identifier
1235439100
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.138864 Issued in OH
Practice address
600 Freedom Dr
Napoleon, OH 43545-9038
Phone
(419) 599-1660
Fax
(419) 592-8336
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 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.138864 OH Primary

Addresses

Primary practice location

600 Freedom Dr
Napoleon, OH 43545-9038

Mailing address

1732 Cross Creek LN
Defiance, OH 43512-3650
Phone (419) 784-2928

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.138864OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1235439100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 CROSS CREEK LN",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435123650",
            "telephone_number": "419-784-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FREEDOM DR",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459038",
            "telephone_number": "419-599-1660",
            "fax_number": "419-592-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "CYNTHIA",
        "middle_name": "MICHELLE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.138864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napoleon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.