Individual provider Active NPI

Kelli Lyn Himes, LPN

  • Licensed Practical Nurse
  • Buffalo, NY
National Provider Identifier
1275878225
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
311088 Issued in NY
Practice address
3495 Bailey Ave
Buffalo, NY 14215-1129
Phone
(716) 834-9200
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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 311088 NY Primary

Addresses

Primary practice location

3495 Bailey Ave
Buffalo, NY 14215-1129

Mailing address

164 Barnstead Dr Apt 5
Springville, NY 14141-1086
Phone (716) 572-9752

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
311088NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1275878225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 BARNSTEAD DR APT 5",
            "city": "SPRINGVILLE",
            "state": "NY",
            "postal_code": "141411086",
            "telephone_number": "716-572-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-834-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMES",
        "first_name": "KELLI",
        "middle_name": "LYN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "311088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.