Individual provider Active NPI

Tina Anderson, LPN

  • Licensed Practical Nurse
  • Xenia, OH
National Provider Identifier
1598044604
Registry record updated Aug 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.133740-M-IV Issued in OH
Practice address
495 S Columbus St
Xenia, OH 45385-5652
Phone
(937) 371-5148
NPI assigned
Aug 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2011

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 PN.133740-M-IV OH Primary

Addresses

Primary practice location

495 S Columbus St
Xenia, OH 45385-5652

Mailing address

495 S Columbus St
Xenia, OH 45385-5652
Phone (937) 371-5148

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
PN.133740-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1312675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312675200000",
    "number": "1598044604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 S COLUMBUS ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453855652",
            "telephone_number": "937-371-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 S COLUMBUS ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453855652",
            "telephone_number": "937-371-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TINA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-07",
        "last_updated": "2011-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.133740-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2011; 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.