Individual provider Active NPI

Shaparis Denmark

  • Custodial Care Facility
  • Jacksonville, FL
National Provider Identifier
1104773852
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
Practice address
5868 Lenox Ave
Jacksonville, FL 32205-6381
Phone
(904) 347-0677
NPI assigned
Mar 12, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X FL Primary

Addresses

Primary practice location

5868 Lenox Ave
Jacksonville, FL 32205-6381

Mailing address

136 Creekmore Dr
St Augustine, FL 32092-3252
Phone (904) 347-0677

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": "1773273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1104773852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CREEKMORE DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923252",
            "telephone_number": "904-347-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5868 LENOX AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056381",
            "telephone_number": "904-347-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENMARK",
        "first_name": "SHAPARIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "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 12, 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.