Malissa Masiongale

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

34458 Issued in TN

Practice address

5880 Bradford Hicks Dr
TN Dept of Health
Livingston, TN 38570-2236

Phone

(931) 823-6260

NPI assigned

Feb 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992831994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 OAKLEY ALLONS RD",
            "city": "ALLONS",
            "state": "TN",
            "postal_code": "385416924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 BRADFORD HICKS DR",
            "address_2": "TN DEPT OF HEALTH",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385702236",
            "telephone_number": "931-823-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASIONGALE",
        "first_name": "MALISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "34458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Mahan, CCC-SLP
• Jennifer Malone
• Tori Mariusso, DMD
• Mark D Nowell
• Joseph E. Martin, PHARM. D.
• Janet P Matson, MS,OTR/L
• Brittany Nicole Matthews, OTR/L
• Brianna Mays
• Elisha Mays
• Carol McCollough

• All providers in Livingston, TN
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.