Individual provider Active NPI

Shawn Desiree Floyd I, LPN

  • Licensed Practical Nurse
  • Potterville, MI
National Provider Identifier
1508999467
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703109919 Issued in MI
Practice address
212 Adams CT
Potterville, MI 48876-9501
Phone
(517) 599-0425
Fax
(419) 492-9506
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN113942 OH
Licensed Practical Nurse 164W00000X 4703109919 MI Primary

Addresses

Primary practice location

212 Adams CT
Potterville, MI 48876-9501

Mailing address

212 Adams CT
Potterville, MI 48876-9501
Phone (517) 599-0425

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

LicenseStateTypeSpecialty
4703109919MIMDLicensed Practical Nurse
PN113942OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1508999467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ADAMS CT",
            "city": "POTTERVILLE",
            "state": "MI",
            "postal_code": "488769501",
            "telephone_number": "517-599-0425",
            "fax_number": "419-492-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 ADAMS CT",
            "city": "POTTERVILLE",
            "state": "MI",
            "postal_code": "488769501",
            "telephone_number": "517-599-0425",
            "fax_number": "419-492-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "SHAWN",
        "middle_name": "DESIREE",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN113942",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703109919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potterville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.