Individual provider Active NPI

Andrise Antoine

  • Nurse's Aide
  • Port St Lucie, FL
National Provider Identifier
1154529089
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CNA 108781 Issued in FL
Practice address
518 NW Kilpatrick Ave
Port St Lucie, FL 34983-8719
Phone
(772) 672-5238
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 CNA 108781 FL Primary

Addresses

Primary practice location

518 NW Kilpatrick Ave
Port St Lucie, FL 34983-8719

Mailing address

518 NW Kilpatrick Ave
Port St Lucie, FL 34983-8719

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
CNA 108781FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154529089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 NW KILPATRICK AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349838719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 NW KILPATRICK AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349838719",
            "telephone_number": "772-672-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "ANDRISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "CNA 108781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.