Individual provider Active NPI

Shavonna Jewdeyah Israel

  • Doula
  • Jacksonville, FL
National Provider Identifier
1356932610
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
2232 Mission Creek CT
Jacksonville, FL 32218-8818
Phone
(904) 252-0661
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X Primary

Addresses

Primary practice location

2232 Mission Creek CT
Jacksonville, FL 32218-8818

Mailing address

5549 Fort Caroline Rd # 123
Jacksonville, FL 32277-1748
Phone (904) 252-0661

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
Doulas Divine Community Services LLC Doula CurrentSince Mar 12, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1356932610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5549 FORT CAROLINE RD # 123",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771748",
            "telephone_number": "904-252-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 MISSION CREEK CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188818",
            "telephone_number": "904-252-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "SHAVONNA",
        "middle_name": "JEWDEYAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "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 Dec 20, 2022; 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.