Individual provider Active NPI

Melanie Diane George, LPN

  • Licensed Practical Nurse
  • Christopher, IL
National Provider Identifier
1982989372
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043100469 Issued in IL
Practice address
4241 Hwy 14 West
Christopher, IL 62822
Phone
(618) 724-2436
Fax
(618) 724-2571
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043100469 IL Primary

Addresses

Primary practice location

4241 Hwy 14 West
Christopher, IL 62822

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2436

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
043100469ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1982989372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2436",
            "fax_number": "618-724-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 HWY 14 WEST",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62822",
            "telephone_number": "618-724-2436",
            "fax_number": "618-724-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MELANIE",
        "middle_name": "DIANE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043100469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christopher, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.