Individual provider Active NPI

Sheldon Jefferson

  • Home Health Aide
  • Zephyrhills, FL
National Provider Identifier
1043938962
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
7613 Merchantville Cir
Zephyrhills, FL 33540-2068
Phone
(813) 810-9397
NPI assigned
Aug 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X FL
Driver 172A00000X
Driving and Community Mobility Occupational Therapy Assistant 224ZR0403X FL
Adult Companion 372600000X
Homemaker 376J00000X 237233 FL
Home Health Aide 374U00000X FL Primary

Addresses

Primary practice location

7613 Merchantville Cir
Zephyrhills, FL 33540-2068

Mailing address

19046 Bruce B Downs Blvd Ste 177
Tampa, FL 33647-2434
Phone (877) 704-7464

Other identifiers 1

IdentifierTypeStateIssuer
1922761782MedicaidFL

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
237233FLMDHomemaker

Practice roles

OrganizationSpecialtyStatusNew patients
S.K.J Management Services LLC CurrentSince Aug 28, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1043938962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19046 BRUCE B DOWNS BLVD STE 177",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472434",
            "telephone_number": "877-704-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7613 MERCHANTVILLE CIR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335402068",
            "telephone_number": "813-810-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SHELDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224ZR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Driving and Community Mobility",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "FL",
            "license": "237233",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922761782",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.