Individual provider Active NPI

Gasner John Fleury, LPN

  • Licensed Practical Nurse
  • Decatur, GA
National Provider Identifier
1285853606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN059064 Issued in GA
Practice address
3073 Panthersville Rd
Decatur, GA 30034-3828
Phone
(404) 212-4790
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LPN059064 GA Primary

Addresses

Primary practice location

3073 Panthersville Rd
Decatur, GA 30034-3828

Mailing address

3964 Sue LN
Decatur, GA 30035-1069
Phone (404) 288-9802

Other identifiers 1

IdentifierTypeStateIssuer
LPN 059064OtherGANURSING

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
LPN059064GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285853606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 SUE LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351069",
            "telephone_number": "404-288-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 PANTHERSVILLE RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300343828",
            "telephone_number": "404-212-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURY",
        "first_name": "GASNER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN059064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING",
            "identifier": "LPN 059064",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.