Individual provider Active NPI

Tatiana Centeio, LPN

  • Licensed Practical Nurse
  • Brockton, MA
National Provider Identifier
1407222458
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN91792 Issued in MA
Practice address
20 Meadowbrook Rd
Brockton, MA 02301-7122
Phone
(508) 638-6003
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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 LN91792 MA Primary

Addresses

Primary practice location

20 Meadowbrook Rd
Brockton, MA 02301-7122

Mailing address

73 Leavitt St Apt 2
Brockton, MA 02301-5163

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
LN91792MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1407222458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 LEAVITT ST APT 2",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122",
            "telephone_number": "508-638-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTEIO",
        "first_name": "TATIANA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN91792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.