Active NPI
Deborahan F Davis, CNA
- Personal Care Attendant
- Homestead, FL
National Provider Identifier
1639431547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 194729
- Practice address
- 34600 Sw188 Ave
Homestead, FL 33034-4519 - Phone
- (786) 339-4036
- NPI assigned
- Jun 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 194729 | FL | Primary |
Addresses
Primary practice location
34600 Sw188 Ave
Homestead, FL 33034-4519
Mailing address
34600 SW 188TH Ave
Homestead, FL 33034-4519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001536100 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 194729 | FL | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1639431547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34600 SW 188TH AVE",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330344519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34600 SW188 AVE",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330344519",
"telephone_number": "786-339-4036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DEBORAHAN",
"middle_name": "F",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-15",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "FL",
"license": "194729",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001536100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.