Individual provider Active NPI

Charteshia T Leonard

  • Licensed Practical Nurse
  • East Palatka, FL
National Provider Identifier
1013597772
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5243094 Issued in FL
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

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PN5243094FLMDLicensed 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.

Verify at the official NPI Registry.