Active NPI
Joseph Lee Easley, PNP
- Pediatric Nurse Practitioner
- Salem, IL
National Provider Identifier
1376539783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN28947
- Practice address
- 1275 Hawthorn Rd
Salem, IL 62881-1028 - Phone
- (618) 548-4590
- Fax
- (618) 548-8275
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN28947 | MT | Primary |
Addresses
Primary practice location
1275 Hawthorn Rd
Salem, IL 62881-1028
Mailing address
1275 Hawthorn Rd
Salem, IL 62881-1028
Phone (618) 548-4590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN28947 | MT | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349913600000",
"number": "1376539783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 HAWTHORN RD",
"city": "SALEM",
"state": "IL",
"postal_code": "628811028",
"telephone_number": "618-548-4590",
"fax_number": "618-548-8275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 HAWTHORN RD",
"city": "SALEM",
"state": "IL",
"postal_code": "628811028",
"telephone_number": "618-548-4590",
"fax_number": "618-548-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASLEY",
"first_name": "JOSEPH",
"middle_name": "LEE",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2012-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MT",
"license": "RN28947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.