Individual provider Active NPI

Tara Tyree, LPN

  • Licensed Practical Nurse
  • Edison, NJ
National Provider Identifier
1689858656
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
26NP05658900 Issued in NJ
Practice address
57 Brookhill Ave
Edison, NJ 08817-3404
Phone
(800) 950-6066
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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 26NP05658900 NJ Primary

Addresses

Primary practice location

57 Brookhill Ave
Edison, NJ 08817-3404

Mailing address

57 Brookhill Ave
Edison, NJ 08817-3404
Phone (800) 950-6066

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
26NP05658900NJMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1689858656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BROOKHILL AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173404",
            "telephone_number": "800-950-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BROOKHILL AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173404",
            "telephone_number": "800-950-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "TARA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP05658900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.