Individual provider Active NPI

Christine Brock Landon, RN

  • Registered Nurse
  • Bartlett, TN
National Provider Identifier
1689241333
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
092816 Issued in AR
Practice address
6112 Piney Bluff Rd
Bartlett, TN 38135-6173
Phone
(901) 232-7557
NPI assigned
Jun 9, 2021
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X 3965 TN
Registered Nurse 163W00000X 092816 AR Primary

Addresses

Primary practice location

6112 Piney Bluff Rd
Bartlett, TN 38135-6173

Mailing address

6112 Piney Bluff Rd
Bartlett, TN 38135-6173
Phone (901) 232-7557

Other identifiers 1

IdentifierTypeStateIssuer
R092816OtherARREGISTERED LICENSE NUMBER

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
092816ARMDRegistered Nurse
3965TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1689241333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 PINEY BLUFF RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381356173",
            "telephone_number": "901-232-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 PINEY BLUFF RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381356173",
            "telephone_number": "901-232-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDON",
        "first_name": "CHRISTINE",
        "middle_name": "BROCK",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "TN",
            "license": "3965",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "092816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED LICENSE NUMBER",
            "identifier": "R092816",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.