Individual provider Active NPI

Rosa Vines

  • Nurse's Aide
  • Jacksonville, FL
National Provider Identifier
1083075220
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CNA147782 Issued in FL
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

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
CNA147782FLMDNurse's Aide
CNA14178582GAMDNurse's Aide
50175752KYMDNurse's Aide
322212421103OHMDNurse'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.

Verify at the official NPI Registry.