Justine Koerner Tye, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

160512 Issued in NC

Practice address

1350 S Kings Dr
Charlotte, NC 28207-2134

Phone

(704) 446-1422

Fax

(704) 446-1582

NPI assigned

Sep 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1366724098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601372",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601372",
            "telephone_number": "704-446-1422",
            "fax_number": "704-446-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-1422",
            "fax_number": "704-446-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYE",
        "first_name": "JUSTINE",
        "middle_name": "KOERNER",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5005317",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "160512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366724098",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2580",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558308080",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine D Twerdi, MD
• Felicia Marie Twiford, ATC, LAT
• Madalyn Olivia Twist, LCSWA
• Kisuk A Twogood, ANP
• Howard William Tyas Jr., D.MIN., PHD
• Sakhet Tyehimba, DOULA
• Tyler Klein DDS PLLC
• Eric Tyler, AUD
• Wesley Tyler
• Sydney Elizabeth Tymula, M.A., CCC-SLP

• Pediatric Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.