Individual provider Active NPI

Jamila Knakia Hargrave, LPN

  • Licensed Practical Nurse
  • Dayton, OH
National Provider Identifier
1538343975
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN122328 Issued in OH
Practice address
315 Pleasant Ave
Dayton, OH 45403-2731
Phone
(937) 262-7524
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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 PN122328 OH Primary

Addresses

Primary practice location

315 Pleasant Ave
Dayton, OH 45403-2731

Mailing address

315 Pleasant Ave
Dayton, OH 45403-2731
Phone (937) 262-7524

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
PN122328OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1538343975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 PLEASANT AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454032731",
            "telephone_number": "937-262-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 PLEASANT AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454032731",
            "telephone_number": "937-262-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGRAVE",
        "first_name": "JAMILA",
        "middle_name": "KNAKIA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN122328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.