Individual provider Active NPI

Cathy Lynn Schallenberg, R.N.

  • Registered Nurse
  • Granite City, IL
National Provider Identifier
1245478106
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
107906 Issued in MO
Practice address
1164 Saint Thomas Rd
Granite City, IL 62040-7003
Phone
(618) 797-6587
NPI assigned
Jan 30, 2009
Last updated
Jan 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 107906 MO Primary

Addresses

Primary practice location

1164 Saint Thomas Rd
Granite City, IL 62040-7003

Mailing address

1164 Saint Thomas Rd
Granite City, IL 62040-7003
Phone (618) 797-6587

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
107906MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1245478106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 SAINT THOMAS RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620407003",
            "telephone_number": "618-797-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 SAINT THOMAS RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620407003",
            "telephone_number": "618-797-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLENBERG",
        "first_name": "CATHY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "107906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.