Individual provider Active NPI

Tyree Alewine Jr., LVN

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1477805299
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
264074 Issued in CA
Practice address
5216 E Liberty Ave
4556 W Palo Alta Ave
Fresno, CA 93727-5220
Phone
(559) 513-9630
Fax
(559) 255-6318
NPI assigned
Oct 3, 2012
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 264074 CA Primary

Addresses

Primary practice location

5216 E Liberty Ave
4556 W Palo Alta Ave
Fresno, CA 93727-5220

Mailing address

5216 E Liberty Ave
4556 W Palo Alta Ave
Fresno, CA 93727-5220
Phone (559) 513-9630

Other names 1

  • Mr. Tyree Alewine Jr. Professional name

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
264074CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1477805299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5216 E LIBERTY AVE",
            "address_2": "4556 W PALO ALTA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937275220",
            "telephone_number": "559-513-9630",
            "fax_number": "559-255-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5216 E LIBERTY AVE",
            "address_2": "4556 W PALO ALTA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937275220",
            "telephone_number": "559-513-9630",
            "fax_number": "559-255-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEWINE",
        "first_name": "TYREE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "264074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYREE",
            "last_name": "ALEWINE",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "LVN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.