Individual provider Active NPI

Kathleen M Tyo, LPN

  • Licensed Practical Nurse
  • Utica, NY
National Provider Identifier
1679892665
Registry record updated May 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
091852-1 Issued in NY
Practice address
2614 Genesee St
Utica, NY 13502-6003
Phone
(315) 793-0090
NPI assigned
May 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2010

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 091852-1 NY Primary

Addresses

Primary practice location

2614 Genesee St
Utica, NY 13502-6003

Mailing address

409 1St Avenue Ext
Frankfort, NY 13340-3516
Phone (315) 868-7559

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
091852-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275264000000",
    "number": "1679892665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 1ST AVENUE EXT",
            "city": "FRANKFORT",
            "state": "NY",
            "postal_code": "133403516",
            "telephone_number": "315-868-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003",
            "telephone_number": "315-793-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYO",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2010-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "091852-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2010; 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.