Individual provider Active NPI

Payton Lynn Faxon

  • Licensed Practical Nurse
  • Grand Island, NE
National Provider Identifier
1679495147
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
28843 Issued in NE
Practice address
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Phone
(308) 389-5155
NPI assigned
Jul 28, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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 28843 NE Primary

Addresses

Primary practice location

2201 N Broadwell Ave
Grand Island, NE 68803-2153

Mailing address

2201 N Broadwell Ave
Grand Island, NE 68803-2153
Phone (308) 389-5155

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

NPI Registry JSON

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

{
    "created_epoch": "1785196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1679495147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 N BROADWELL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032153",
            "telephone_number": "308-389-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N BROADWELL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032153",
            "telephone_number": "308-389-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAXON",
        "first_name": "PAYTON",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-28",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NE",
            "license": "28843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.