Individual provider Active NPI

Cierra Elizabeth Carter

  • Licensed Practical Nurse
  • Jacksonville, FL
National Provider Identifier
1184285652
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5239907 Issued in FL
Practice address
906 W Monroe St Apt 401
Jacksonville, FL 32204-1184
Phone
(904) 382-8944
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 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 PN5239907 FL Primary

Addresses

Primary practice location

906 W Monroe St Apt 401
Jacksonville, FL 32204-1184

Mailing address

2020 W 6TH St
Jacksonville, FL 32209-5871
Phone (904) 382-8944

Other identifiers 1

IdentifierTypeStateIssuer
5239907MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a Other

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
PN5239907FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1184285652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W 6TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322095871",
            "telephone_number": "904-382-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W MONROE ST APT 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041184",
            "telephone_number": "904-382-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "CIERRA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5239907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5239907",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "JACKSONVILLE",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "JACKSONVILLE",
            "address_1": "906 W Monroe St Apt 401",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322041184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 25, 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.