Individual provider Active NPI

Kaylee Waskom, LVN

  • Licensed Vocational Nurse
  • Longview, TX
National Provider Identifier
1306493382
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
315520 Issued in TX
Practice address
301 W Hawkins Pkwy Apt 213
Longview, TX 75605-1819
Phone
(903) 930-6156
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 315520 TX Primary

Addresses

Primary practice location

301 W Hawkins Pkwy Apt 213
Longview, TX 75605-1819

Mailing address

301 W Hawkins Pkwy Apt 213
Longview, TX 75605-1819
Phone (903) 930-6156

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
315520TXMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1306493382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W HAWKINS PKWY APT 213",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756051819",
            "telephone_number": "903-930-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W HAWKINS PKWY APT 213",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756051819",
            "telephone_number": "903-930-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASKOM",
        "first_name": "KAYLEE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "315520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.