Active NPI
Rosa Vines
- Nurse's Aide
- Jacksonville, FL
National Provider Identifier
1083075220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CNA147782
- Practice address
- 900 Bert Rd Apt F134
Jacksonville, FL 32211 - Phone
- (912) 631-0158
- NPI assigned
- Mar 16, 2016
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 50175752 | KY | |
| Nurse's Aide | 376K00000X | CNA147782 | FL | Primary |
| Nurse's Aide | 376K00000X | 322212421103 | OH | |
| Nurse's Aide | 376K00000X | CNA14178582 | GA |
Addresses
Primary practice location
900 Bert Rd Apt F134
Jacksonville, FL 32211
Mailing address
900 Bert Rd Apt F134
Jacksonville, FL 32211-5963
Phone (912) 631-0158
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 |
|---|---|---|---|
| CNA147782 | FL | MD | Nurse's Aide |
| CNA14178582 | GA | MD | Nurse's Aide |
| 50175752 | KY | MD | Nurse's Aide |
| 322212421103 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1083075220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 BERT RD APT F134",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322115963",
"telephone_number": "912-631-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 BERT RD APT F134",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32211",
"telephone_number": "912-631-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINES",
"first_name": "ROSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "KY",
"license": "50175752",
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "FL",
"license": "CNA147782",
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "322212421103",
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "GA",
"license": "CNA14178582",
"primary": false
}
],
"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 Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.