Individual provider Active NPI

Cametra L Gibson-Bryant, CNA366895

  • Nurse's Aide
  • Havana, FL
National Provider Identifier
1134717853
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CNA366895 Issued in FL
Practice address
7123 Havana Hwy
Havana, FL 32333-5327
Phone
(850) 322-0489
NPI assigned
Jan 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CNA366895 FL Primary

Addresses

Primary practice location

7123 Havana Hwy
Havana, FL 32333-5327

Mailing address

PO Box 953
Havana, FL 32333-0953
Phone (850) 322-0489

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
CNA366895FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1134717853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 953",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323330953",
            "telephone_number": "850-322-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7123 HAVANA HWY",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323335327",
            "telephone_number": "850-322-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON-BRYANT",
        "first_name": "CAMETRA",
        "middle_name": "L",
        "credential": "CNA366895",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "CNA366895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havana, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.