Individual provider Active NPI

Rodneisha Fair

  • Nurse's Aide
  • Tampa, FL
National Provider Identifier
1194567990
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CNA388648 Issued in FL
Practice address
1350 W Chestnut St Unit 812
Tampa, FL 33607-4439
Phone
(813) 858-6932
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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 CNA388648 FL Primary

Addresses

Primary practice location

1350 W Chestnut St Unit 812
Tampa, FL 33607-4439

Mailing address

1315 Oakfield Dr # 752
Brandon, FL 33511-4852

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
CNA388648FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1194567990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 OAKFIELD DR # 752",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W CHESTNUT ST UNIT 812",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336074439",
            "telephone_number": "813-858-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "RODNEISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "CNA388648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.