Individual provider Active NPI

Takenya S Lampkins

  • Exercise & Sports Psychologist
  • Jacksonville, FL
National Provider Identifier
1205507241
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exercise & Sports PsychologistTaxonomy code 103TE1100X
Practice address
8106 Old Kings Rd S Ste 4
Jacksonville, FL 32217-5526
Phone
(904) 586-2118
NPI assigned
Sep 21, 2021
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Exercise & Sports Psychologist 103TE1100X Primary

Addresses

Primary practice location

8106 Old Kings Rd S Ste 4
Jacksonville, FL 32217-5526

Mailing address

8106 Old Kings Rd S Ste 4
Jacksonville, FL 32217-5526
Phone (904) 586-2118

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

Practice roles

OrganizationSpecialtyStatusNew patients
Four Friends Fitness LLC Exercise & Sports CurrentSince Dec 26, 2021 Accepting new patients

Locations

8106 Old Kings Rd S
Ste 4
Jacksonville, FL 32217
Phone (904) 586-2118

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1205507241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8106 OLD KINGS RD S STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322175526",
            "telephone_number": "904-586-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8106 OLD KINGS RD S STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322175526",
            "telephone_number": "904-586-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPKINS",
        "first_name": "TAKENYA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 21, 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.