Individual provider Active NPI

Katrina Jevon Nelson, CCHW

  • Doula
  • Winter Garden, FL
National Provider Identifier
1093294365
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
213 S Dillard St Ste 340
Winter Garden, FL 34787-3596
Phone
(407) 656-6938
Fax
(844) 560-2349
NPI assigned
Aug 8, 2018
Last updated
Sep 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Doula 374J00000X Primary

Addresses

Primary practice location

213 S Dillard St Ste 340
Winter Garden, FL 34787-3596

Mailing address

213 S Dillard St Ste 340
Winter Garden, FL 34787-3596
Phone (407) 656-6938

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1093294365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S DILLARD ST STE 340",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873596",
            "telephone_number": "407-656-6938",
            "fax_number": "844-560-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S DILLARD ST STE 340",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873596",
            "telephone_number": "407-656-6938",
            "fax_number": "844-560-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KATRINA",
        "middle_name": "JEVON",
        "credential": "CCHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.