Individual provider Active NPI

Christie Lashun Killebrew, LPN

  • Licensed Practical Nurse
  • Cleveland, OH
National Provider Identifier
1407106313
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
129551 Issued in OH
Practice address
1498 E 175TH St
Cleveland, OH 44110-2939
Phone
(216) 383-1485
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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 129551 OH Primary

Addresses

Primary practice location

1498 E 175TH St
Cleveland, OH 44110-2939

Mailing address

1498 E 175TH St
Cleveland, OH 44110-2939
Phone (216) 383-1485

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
129551OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1407106313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 E 175TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102939",
            "telephone_number": "216-383-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 E 175TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102939",
            "telephone_number": "216-383-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEBREW",
        "first_name": "CHRISTIE",
        "middle_name": "LASHUN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "129551",
            "primary": true
        }
    ],
    "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 Feb 19, 2013; 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.