Individual provider Active NPI

Beanca Lotin, LPN

  • Licensed Practical Nurse
  • Orange Park, FL
National Provider Identifier
1154967271
Registry record updated Nov 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5242369 Issued in FL
Practice address
3077 Tower Oaks Dr
Orange Park, FL 32065-2546
Phone
(904) 405-0892
NPI assigned
Nov 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2019

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 PN5242369 FL Primary

Addresses

Primary practice location

3077 Tower Oaks Dr
Orange Park, FL 32065-2546

Mailing address

3077 Tower Oaks Dr
Orange Park, FL 32065-2546
Phone (904) 405-0892

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
PN5242369FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1574553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574553600000",
    "number": "1154967271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 TOWER OAKS DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652546",
            "telephone_number": "904-405-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 TOWER OAKS DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652546",
            "telephone_number": "904-405-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTIN",
        "first_name": "BEANCA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-24",
        "last_updated": "2019-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5242369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2019; 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.