Individual provider Active NPI

Shatesse Bush

  • Licensed Practical Nurse
  • Jacksonville, FL
National Provider Identifier
1427972777
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5237890 Issued in FL
Practice address
11050 Harts Rd Apt 1801
Jacksonville, FL 32218-3769
Phone
(904) 684-2998
NPI assigned
Aug 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5237890 FL Primary

Addresses

Primary practice location

11050 Harts Rd Apt 1801
Jacksonville, FL 32218-3769

Mailing address

11050 Harts Rd Apt 1801
Jacksonville, FL 32218-3769
Phone (904) 684-2998

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": "1786147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1427972777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 HARTS RD APT 1801",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183769",
            "telephone_number": "904-684-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 HARTS RD APT 1801",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183769",
            "telephone_number": "904-684-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "SHATESSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-08",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5237890",
            "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 Aug 8, 2026; 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.