Individual provider Active NPI

Shasta Michelle Byrd, CNA

  • Home Health Aide
  • Winter Haven, FL
National Provider Identifier
1104132760
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
156966 Issued in FL
Practice address
91 Surf Dr
Winter Haven, FL 33880-5756
Phone
(863) 325-8424
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 156966 FL Primary

Addresses

Primary practice location

91 Surf Dr
Winter Haven, FL 33880-5756

Mailing address

2726 Old Eagle Lake Winter Haven Rd
Lot 4
Eagle Lake, FL 33839-5402
Phone (863) 595-6865

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
156966FLMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1104132760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 OLD EAGLE LAKE WINTER HAVEN RD",
            "address_2": "LOT 4",
            "city": "EAGLE LAKE",
            "state": "FL",
            "postal_code": "338395402",
            "telephone_number": "863-595-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 SURF DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338805756",
            "telephone_number": "863-325-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "SHASTA",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "156966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.