Organization Active NPI

Sharonda R. Hussey

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Jacksonville, FL
National Provider Identifier
1558736587
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
Legal business name
SHARONDA R. HUSSEY
Practice address
11501 Brian Lakes Dr
Jacksonville, FL 32221-2849
Phone
(904) 229-1884
NPI assigned
Dec 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Ms. Sharonda HusseyNPI 1164899308
Title
Provider
Phone
(904) 229-1884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X FL
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X FL Primary

Addresses

Primary practice location

11501 Brian Lakes Dr
Jacksonville, FL 32221-2849

Mailing address

11501 Brian Lakes Dr
Jacksonville, FL 32221-2849
Phone (904) 229-1884

Other identifiers 1

IdentifierTypeStateIssuer
015805400MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1558736587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11501 BRIAN LAKES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322212849",
            "telephone_number": "904-229-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 BRIAN LAKES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322212849",
            "telephone_number": "904-229-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARONDA R. HUSSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "HUSSEY",
        "authorized_official_first_name": "SHARONDA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "904-229-1884",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015805400",
            "state": "FL"
        }
    ],
    "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 Dec 2, 2015; 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.