NPIMap

Organization Active NPI

Kimberly Tallon

  • Home Health Agency
  • Lake Grove, NY
National Provider Identifier
1609173012
Registry record updated Feb 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
294449-1 Issued in NY
Legal business name
KIMBERLY TALLON
Practice address
10 Connelly Dr
Lake Grove, NY 11755-2966
Phone
(631) 889-6178
NPI assigned
Feb 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2011

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

Authorized official

Name
Miss Kimberly Sue TallonNPI 1932490257
Title
Licensed Practical Nurse
Phone
(631) 889-6178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 294449-1 NY Primary

Addresses

Primary practice location

10 Connelly Dr
Lake Grove, NY 11755-2966

Mailing address

10 Connelly Dr
Lake Grove, NY 11755-2966

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1609173012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CONNELLY DR",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONNELLY DR",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552966",
            "telephone_number": "631-889-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY TALLON",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "TALLON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "LICENSED PRACTICAL NURSE",
        "authorized_official_telephone_number": "631-889-6178",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "294449-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.