Individual provider Active NPI

Nekisha C Chavers, LPN

  • Licensed Practical Nurse
  • Canton, OH
National Provider Identifier
1063806545
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
157540 Issued in OH
Practice address
7300 Beverly Ave NE Apt 10
Canton, OH 44721-2053
Phone
(330) 915-0485
NPI assigned
Mar 24, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 157540 OH Primary

Addresses

Primary practice location

7300 Beverly Ave NE Apt 10
Canton, OH 44721-2053

Mailing address

7300 Beverly Ave NE Apt 10
Canton, OH 44721
Phone (330) 915-0485

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
157540OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063806545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 BEVERLY AVE NE APT 10",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44721",
            "telephone_number": "330-915-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 BEVERLY AVE NE APT 10",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212053",
            "telephone_number": "330-915-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVERS",
        "first_name": "NEKISHA",
        "middle_name": "C",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "157540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.