Active NPI
Annamma Varghese, LPN
- Licensed Practical Nurse
- Lakeland, FL
National Provider Identifier
1700103363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5190201
- Practice address
- 138 Shannon Oaks Dr
Lakeland, FL 33813-5664 - Phone
- (407) 334-6328
- NPI assigned
- Apr 22, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN5190201 | FL | Primary |
Addresses
Primary practice location
138 Shannon Oaks Dr
Lakeland, FL 33813-5664
Mailing address
138 Shannon Oaks Dr
Lakeland, FL 33813-5664
Phone (407) 334-6328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PN 5190201 | Other | FL | LPN LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PN5190201 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271894400000",
"number": "1700103363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 SHANNON OAKS DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338135664",
"telephone_number": "407-334-6328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 SHANNON OAKS DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338135664",
"telephone_number": "407-334-6328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGHESE",
"first_name": "ANNAMMA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-22",
"last_updated": "2010-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5190201",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPN LICENSE",
"identifier": "PN 5190201",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.