Active NPI
Mary Magdeline Talley, CNA
- Nurse's Aide
- Kernersville, NC
National Provider Identifier
1245085711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 587348
- Practice address
- 6109 Heathbrook LN
Kernersville, NC 27284-8715 - Phone
- (336) 564-6025
- NPI assigned
- Apr 18, 2024
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 587348 | NC | Primary |
Addresses
Primary practice location
6109 Heathbrook LN
Kernersville, NC 27284-8715
Mailing address
6109 Heathbrook LN
Kernersville, NC 27284-8715
Phone (336) 564-6025
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 |
|---|---|---|---|
| 587348 | NC | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1245085711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6109 HEATHBROOK LN",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272848715",
"telephone_number": "336-564-6025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6109 HEATHBROOK LN",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272848715",
"telephone_number": "336-564-6025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLEY",
"first_name": "MARY",
"middle_name": "MAGDELINE",
"name_prefix": "Mrs.",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-18",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "NC",
"license": "587348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.