Individual provider Active NPI

Shannon Rose Lesky, RN

  • Home Health Registered Nurse
  • Rochester, MN
National Provider Identifier
1477052348
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
222198 Issued in WI
Practice address
1450 2ND Ave SW
Rochester, MN 55902-2113
Phone
(608) 475-0629
NPI assigned
Feb 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WH0200X 222198 WI Primary

Addresses

Primary practice location

1450 2ND Ave SW
Rochester, MN 55902-2113

Mailing address

7661 Jackpot Ave
Sparta, WI 54656-3813
Phone (608) 475-0629

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
222198WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1477052348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7661 JACKPOT AVE",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546563813",
            "telephone_number": "608-475-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 2ND AVE SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022113",
            "telephone_number": "608-475-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESKY",
        "first_name": "SHANNON",
        "middle_name": "ROSE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "222198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.