Individual provider Active NPI

Sisamouth Sipaseuth Thomure, LVN

  • Licensed Vocational Nurse
  • San Jose, CA
National Provider Identifier
1851760763
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
231848 Issued in CA
Practice address
650 S 5TH St
San Jose, CA 95112-5636
Phone
(408) 982-5779
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 231848 CA Primary

Addresses

Primary practice location

650 S 5TH St
San Jose, CA 95112-5636

Mailing address

1400 Bowe Ave Apt 703
Santa Clara, CA 95051-3834
Phone (559) 740-6019

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
231848CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1851760763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BOWE AVE APT 703",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950513834",
            "telephone_number": "559-740-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S 5TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125636",
            "telephone_number": "408-982-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMURE",
        "first_name": "SISAMOUTH",
        "middle_name": "SIPASEUTH",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "231848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.