Individual provider Active NPI

Leatoa Charlonne Afuola

  • Licensed Practical Nurse
  • Tacoma, WA
National Provider Identifier
1497235907
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP60598611 Issued in WA
Practice address
9720 S Tacoma Way
Tacoma, WA 98499-4456
Phone
(253) 503-3666
NPI assigned
Aug 15, 2018
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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 LP60598611 WA Primary

Addresses

Primary practice location

9720 S Tacoma Way
Tacoma, WA 98499-4456

Mailing address

9720 S Tacoma Way
Tacoma, WA 98499-4456
Phone (253) 503-3666

Other identifiers 1

IdentifierTypeStateIssuer
2001900MedicaidWA

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
LP60598611WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1497235907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 S TACOMA WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984994456",
            "telephone_number": "253-503-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 S TACOMA WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984994456",
            "telephone_number": "253-503-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFUOLA",
        "first_name": "LEATOA",
        "middle_name": "CHARLONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60598611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001900",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.