Individual provider Active NPI

Quernecia Caldwell

  • Prosthetics Case Management
  • Melbourne, FL
National Provider Identifier
1083104954
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
4690 Lipscomb St NE Ste 5B
Melbourne, FL 32905-2929
Phone
(321) 327-2946
NPI assigned
May 15, 2018
Last updated
May 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X NU Primary

Addresses

Primary practice location

4690 Lipscomb St NE Ste 5B
Melbourne, FL 32905-2929

Mailing address

4690 Lipscomb St NE Ste 5B
Melbourne, FL 32905-2929
Phone (321) 327-2946

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": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1083104954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 LIPSCOMB ST NE STE 5B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329052929",
            "telephone_number": "321-327-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 LIPSCOMB ST NE STE 5B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329052929",
            "telephone_number": "321-327-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "QUERNECIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.