Individual provider Active NPI

Conard Jay Osbourn, RN

  • Registered Nurse
  • Liberty Hill, TX
National Provider Identifier
1982104774
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
795864 Issued in TX
Practice address
118 Milestone Rd
Liberty Hill, TX 78642-4409
Phone
(512) 997-8817
Fax
(512) 997-8817
NPI assigned
Feb 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 795864 TX Primary

Addresses

Primary practice location

118 Milestone Rd
Liberty Hill, TX 78642-4409

Mailing address

118 Milestone Rd
Liberty Hill, TX 78642-4409
Phone (512) 997-8817

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
795864TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1982104774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MILESTONE RD",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424409",
            "telephone_number": "512-997-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MILESTONE RD",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424409",
            "telephone_number": "512-997-8817",
            "fax_number": "512-997-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBOURN",
        "first_name": "CONARD",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "795864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.