Individual provider Active NPI

Luc Kiebre, RN

  • Registered Nurse
  • Cleveland, OH
National Provider Identifier
1356622682
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
355927 Issued in OH
Practice address
12600 Shaker Blvd
Apt 205
Cleveland, OH 44120-2065
Phone
(216) 526-9754
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 355927 OH Primary
Infusion Therapy Registered Nurse 163WI0500X 355927 OH
Wound Care Registered Nurse 163WW0000X 355927 OH

Addresses

Primary practice location

12600 Shaker Blvd
Apt 205
Cleveland, OH 44120-2065

Mailing address

12600 Shaker Blvd
Apt 205
Cleveland, OH 44120-2065
Phone (216) 526-9754

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
355927OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1356622682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 SHAKER BLVD",
            "address_2": "APT 205",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202065",
            "telephone_number": "216-526-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 SHAKER BLVD",
            "address_2": "APT 205",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202065",
            "telephone_number": "216-526-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEBRE",
        "first_name": "LUC",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "355927",
            "primary": true
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "OH",
            "license": "355927",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "OH",
            "license": "355927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.