Active NPI
Luz Medy Lebron Monclova, RN
- Nursing Home Administrator
- Jacksonville, FL
National Provider Identifier
1578915070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- RN9227949
- Practice address
- 5681 Edenfield Rd
Apt. 1005
Jacksonville, FL 32277-1469 - Phone
- (904) 314-9156
- NPI assigned
- Jul 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | RN9227949 | FL | Primary |
Addresses
Primary practice location
5681 Edenfield Rd
Apt. 1005
Jacksonville, FL 32277-1469
Mailing address
5681 Edenfield Rd
Apt. 1005
Jacksonville, FL 32277-1469
Phone (904) 314-9156
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN9227949 | FL | MD | Nursing Home Administrator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1578915070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5681 EDENFIELD RD",
"address_2": "APT. 1005",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322771469",
"telephone_number": "904-314-9156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5681 EDENFIELD RD",
"address_2": "APT. 1005",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322771469",
"telephone_number": "904-314-9156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBRON MONCLOVA",
"first_name": "LUZ",
"middle_name": "MEDY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-07",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "FL",
"license": "RN9227949",
"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 Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.