Active NPI
Charteshia T Leonard
- Licensed Practical Nurse
- East Palatka, FL
National Provider Identifier
1013597772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5243094
- Practice address
- 110 Sweetgum Rd
East Palatka, FL 32131-4203 - Phone
- (386) 538-4620
- NPI assigned
- Apr 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | |||
| Home Health Agency | 251E00000X | |||
| Licensed Practical Nurse | 164W00000X | PN5243094 | FL | Primary |
Addresses
Primary practice location
110 Sweetgum Rd
East Palatka, FL 32131-4203
Mailing address
110 Sweetgum Rd
East Palatka, FL 32131-4203
Phone (386) 538-4620
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 |
|---|---|---|---|
| PN5243094 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1013597772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 SWEETGUM RD",
"city": "EAST PALATKA",
"state": "FL",
"postal_code": "321314203",
"telephone_number": "386-538-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 SWEETGUM RD",
"city": "EAST PALATKA",
"state": "FL",
"postal_code": "321314203",
"telephone_number": "386-538-4620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONARD",
"first_name": "CHARTESHIA",
"middle_name": "T",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-08",
"last_updated": "2021-04-08",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5243094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Palatka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.