Active NPI
Taree Patillo
- Licensed Practical Nurse
- Louisville, KY
National Provider Identifier
1982160453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 2053107
- Practice address
- 410 Bermuda LN
Louisville, KY 40213-3318 - Phone
- (502) 203-5130
- NPI assigned
- Feb 20, 2019
- 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 | 2053107 | KY | Primary |
Addresses
Primary practice location
410 Bermuda LN
Louisville, KY 40213-3318
Mailing address
410 Bermuda LN
Louisville, KY 40213-3318
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 |
|---|---|---|---|
| 2053107 | KY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1982160453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 BERMUDA LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402133318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 BERMUDA LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402133318",
"telephone_number": "502-203-5130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATILLO",
"first_name": "TAREE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-20",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "KY",
"license": "2053107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.