Leecille M Mertz, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

61097501LPN Issued in WA

Practice address

1240 Place St
Baker City, OR 97814-4040

Phone

(541) 519-6647

NPI assigned

Dec 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Leecille M Linnell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1881290989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E 1ST ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 PLACE ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978144040",
            "telephone_number": "541-519-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "LEECILLE",
        "middle_name": "M",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-05",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "61097501LPN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TREATMENT CENTER",
            "identifier": "1568477297",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.acadiahealthcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Treatment center",
            "address_1": "268 Stillwater Ave",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LEECILLE",
            "last_name": "LINNELL",
            "middle_name": "M",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary L McOmber, PHARMD, BCPS
• Kristy Suzann McPherson
• Michael Hugh McQueen, MD
• Meadowbrook Place Operations, LLC
• Memory Lane Homes, LLC
• Leah Michel, LAC, MSOM
• Andrew Micka
• Kathleen Mills
• Jessica Minor, OTR/L
• Logan Thompson Mitchell, O.D.

• Licensed Practical Nurse in Baker City, OR
• Providers in Baker City, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; 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.