Active NPI
Shana Wise
- Home Health Agency
- Jacksonville, FL
National Provider Identifier
1073320180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 9621 Lovage LN
Jacksonville, FL 32219-2219 - Phone
- (904) 444-9079
- NPI assigned
- Dec 12, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
9621 Lovage LN
Jacksonville, FL 32219-2219
Mailing address
9621 Lovage LN
Jacksonville, FL 32219-2219
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1073320180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9621 LOVAGE LN",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322192219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9621 LOVAGE LN",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322192219",
"telephone_number": "904-444-9079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "SHANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-12",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.