Individual provider Active NPI

Sharon Angelica Fowlkes, L.P.N.

  • Case Manager/Care Coordinator
  • Portsmouth, VA
National Provider Identifier
1215420054
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
5812 Dunkirk St
Portsmouth, VA 23703-3128
Phone
(757) 318-8407
Fax
(757) 673-3606
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002079887 VA
Personal Care Attendant 3747P1801X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

5812 Dunkirk St
Portsmouth, VA 23703-3128

Mailing address

5812 Dunkirk St
Portsmouth, VA 23703-3128
Phone (757) 318-8407

Other practice location 1

5416 Tidewater Dr
Norfolk, VA 23509-1437
Phone (757) 318-8407

Other names 1

  • Mrs. Sharon Angelica Spellman, Burke Former name

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
0002079887VAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1215420054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 DUNKIRK ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033128",
            "telephone_number": "757-318-8407",
            "fax_number": "757-673-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 DUNKIRK ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033128",
            "telephone_number": "757-318-8407",
            "fax_number": "757-673-3606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5416 Tidewater Dr",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235091437",
            "country_code": "US",
            "telephone_number": "757-318-8407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "SHARON",
        "middle_name": "ANGELICA",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002079887",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "SPELLMAN, BURKE",
            "middle_name": "ANGELICA",
            "prefix": "MRS.",
            "credential": "C.N.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.