Sally McClenahan, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043082831 Issued in IL

Practice address

9525 Gold Hill Rd
Shawneetown, IL 62984-3659

Phone

(618) 724-2401

NPI assigned

Jul 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sally Lane Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1457874919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 HIGHWAY 14 W",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628221037",
            "telephone_number": "618-724-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 GOLD HILL RD",
            "city": "SHAWNEETOWN",
            "state": "IL",
            "postal_code": "629843659",
            "telephone_number": "618-724-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENAHAN",
        "first_name": "SALLY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043082831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "LANE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Practical Nurse in Shawneetown, IL
• Providers in Shawneetown, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.