Active NPI
Katrina Lefaye James
- Child Intellectual and/or Developmental Disabilities Respite Care
- Jacksonville, FL
National Provider Identifier
1417124892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite Care
- License
- 08IV028
- Practice address
- 3504 North Davis Street
Jacksonville, FL 32209-4456 - Phone
- (904) 632-2019
- Fax
- (904) 632-2019
- NPI assigned
- May 14, 2008
- Last updated
- May 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | 08IV028 | FL | Primary |
| Community Health Worker | 172V00000X | 69042596 | FL |
Addresses
Primary practice location
3504 North Davis Street
Jacksonville, FL 32209-4456
Mailing address
3504 North Davis Street
Jacksonville, FL 32209-4456
Phone (904) 632-2019
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
| License | State | Type | Specialty |
|---|---|---|---|
| 69042596 | FL | MD | Community Health Worker |
| 08IV028 | FL | MD | Child Intellectual and/or Developmental Disabilities Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1417124892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3504 NORTH DAVIS STREET",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322094456",
"telephone_number": "904-632-2019",
"fax_number": "904-632-2019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3504 NORTH DAVIS STREET",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322094456",
"telephone_number": "904-632-2019",
"fax_number": "904-632-2019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "KATRINA",
"middle_name": "LEFAYE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": "FL",
"license": "08IV028",
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "FL",
"license": "69042596",
"primary": false
}
],
"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 May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.