Individual provider Active NPI

Mary Jo Taylor, LPN

  • Licensed Practical Nurse
  • Cherokee, NC
National Provider Identifier
1629221429
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
052135 Issued in NC
Practice address
64 John Crow Hill
Cherokee, NC 28719
Phone
(828) 497-9163
Fax
(828) 497-5343
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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 052135 NC Primary

Addresses

Primary practice location

64 John Crow Hill
Cherokee, NC 28719

Mailing address

64 John Crow Hill
Cherokee, NC 28719
Phone (828) 497-9163

Other identifiers 1

IdentifierTypeStateIssuer
052135OtherNCLPN LIC

Other names 1

  • Mary Jo Queen Former 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
052135NCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1629221429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 JOHN CROW HILL",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "28719",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 JOHN CROW HILL",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "28719",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "052135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN LIC",
            "identifier": "052135",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "QUEEN",
            "middle_name": "JO",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cherokee, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.