NPIMap

Organization Active NPI

Jeanette Gadsden

  • Adult Care Home Facility
  • Port Charlotte, FL
National Provider Identifier
1356788996
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
6906148 Issued in FL
Legal business name
JEANETTE GADSDEN
Practice address
1113 Fleetwood Dr NW
Port Charlotte, FL 33948-2001
Phone
(941) 743-0897
NPI assigned
May 22, 2013
Last updated
May 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Authorized official

Name
Jeanette Gadsden
Title
Owner
Phone
(941) 743-0897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 6906148 FL Primary

Addresses

Primary practice location

1113 Fleetwood Dr NW
Port Charlotte, FL 33948-2001

Mailing address

1113 Fleetwood Drive
Port Charlotte, FL 33948

Other identifiers 1

IdentifierTypeStateIssuer
142896900MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1356788996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 FLEETWOOD DRIVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 FLEETWOOD DR NW",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482001",
            "telephone_number": "941-743-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANETTE GADSDEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "GADSDEN",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-743-0897"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142896900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.