Individual provider Active NPI

Melissa Kay Laslie

  • Registered Nurse
  • Flora, IL
National Provider Identifier
1558879676
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041362664 Issued in IL
Practice address
911 Stacy Burk Drive
Flora, IL 62839
Phone
(618) 662-2191
NPI assigned
Jan 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041362664 IL Primary

Addresses

Primary practice location

911 Stacy Burk Drive
Flora, IL 62839

Mailing address

911 Stacy Burk Drive
Flora, IL 62839

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
041362664ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1558879676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 STACY BURK DRIVE",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "62839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 STACY BURK DRIVE",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "62839",
            "telephone_number": "618-662-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASLIE",
        "first_name": "MELISSA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041362664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.