Charles A Dearborn, LPN0

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P46282 Issued in IA

Practice address

100 Indian Hills Dr.
Macy, NE 68039

Phone

(402) 837-5381

Fax

(402) 837-4216

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659580652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OUTER DR. N. 323",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDIAN HILLS DR.",
            "city": "MACY",
            "state": "NE",
            "postal_code": "68039",
            "telephone_number": "402-837-5381",
            "fax_number": "402-837-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARBORN",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "LPN0",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P46282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Burns, PLMHP
• Linda Calvillo, RN
• Carl T Curtis Health Education Center
• Kelly Olsson Cromer, PHARMD
• Audrey Kay Cross, OTR L
• Sarah Mari Farrens, RN
• Derek A Fender, D.D.S.
• Ronald James Freemont Jr., NREMT I
• Jeffrey Gildow, PHARM.D.
• Robin R Gordon, RN

• All providers in Macy, NE
• Licensed Practical Nurse in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.