Individual provider Active NPI

Shiquita Charmaine Jefferson, R.N.

  • Registered Nurse
  • Albany, GA
National Provider Identifier
1457725335
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN208323 Issued in GA
Practice address
230 S Jackson St Ste 233
Albany, GA 31701-2887
Phone
(229) 347-4394
NPI assigned
Nov 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN208323 GA Primary

Addresses

Primary practice location

230 S Jackson St Ste 233
Albany, GA 31701-2887

Mailing address

174 White Horse Dr
Leesburg, GA 31763-4538
Phone (229) 588-1525

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN208323GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Touch Healthcare LLC CurrentSince Feb 6, 2022 Accepting new patients

Locations

230 S Jackson St
Ste 233
Albany, GA 31701
Phone (229) 347-4394

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": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1457725335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 WHITE HORSE DR",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317634538",
            "telephone_number": "229-588-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S JACKSON ST STE 233",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012887",
            "telephone_number": "229-347-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SHIQUITA",
        "middle_name": "CHARMAINE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN208323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.