Individual provider Active NPI

Sheniqua Davis Pearson

  • Licensed Practical Nurse
  • Lakeland, FL
National Provider Identifier
1124907464
Registry record updated Aug 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
5209348 Issued in FL
Practice address
3445 Ewell Rd
Lakeland, FL 33811-1957
Phone
(863) 777-3909
NPI assigned
Aug 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 5209348 FL Primary

Addresses

Primary practice location

3445 Ewell Rd
Lakeland, FL 33811-1957

Mailing address

PO Box 93414
Lakeland, FL 33804-3414
Phone (863) 777-3909

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
5209348FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1756512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756512000000",
    "number": "1124907464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93414",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338043414",
            "telephone_number": "863-777-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 EWELL RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111957",
            "telephone_number": "863-777-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "SHENIQUA",
        "middle_name": "DAVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-30",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "5209348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2025; 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.