Active NPI
Carl Martin Knisley-Desmond, HOME HEALTH NURSE
- Home Health Aide
- Brooksville, FL
National Provider Identifier
1396477063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 1710569752
- Practice address
- 715 Oakdale Ave Apt 24
Brooksville, FL 34601-1913 - Phone
- (352) 444-0022
- NPI assigned
- Jun 30, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 1710569752 | Primary |
Addresses
Primary practice location
715 Oakdale Ave Apt 24
Brooksville, FL 34601-1913
Mailing address
PO Box 1483
Brooksville, FL 34605-1483
Phone (352) 444-0222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710569752 | Other | HOME HEALTH PROVIDER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1396477063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1483",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346051483",
"telephone_number": "352-444-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 OAKDALE AVE APT 24",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346011913",
"telephone_number": "352-444-0022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNISLEY-DESMOND",
"first_name": "CARL",
"middle_name": "MARTIN",
"name_prefix": "Mr.",
"credential": "HOME HEALTH NURSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-30",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": "1710569752",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME HEALTH PROVIDER",
"identifier": "1710569752",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooksville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.