Individual provider Active NPI

Kenisha Latoya Patterson, LPN

  • Licensed Practical Nurse
  • Maple Heights, OH
National Provider Identifier
1255595161
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.130342 Issued in OH
Practice address
5242 Beech Ave
Maple Heights, OH 44137-1003
Phone
(216) 456-5392
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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.130342 OH Primary

Addresses

Primary practice location

5242 Beech Ave
Maple Heights, OH 44137-1003

Mailing address

5242 Beech Ave
Maple Heights, OH 44137-1003
Phone (216) 456-5392

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.130342OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1255595161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 BEECH AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441371003",
            "telephone_number": "216-456-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5242 BEECH AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441371003",
            "telephone_number": "216-456-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KENISHA",
        "middle_name": "LATOYA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.130342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.