Individual provider Active NPI

Caldon Barnes, RN

  • Registered Nurse
  • Plantation, FL
National Provider Identifier
1639794035
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9536363 Issued in FL
Practice address
1121 NW 111TH Ave
Plantation, FL 33322-7826
Phone
(954) 826-5979
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9536363 FL Primary

Addresses

Primary practice location

1121 NW 111TH Ave
Plantation, FL 33322-7826

Mailing address

1121 NW 111TH Ave
Plantation, FL 33322-7826
Phone (954) 826-5979

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL cpbarnes01@gmail.com Bold Step, LLC

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

LicenseStateTypeSpecialty
RN9536363FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bold Step, LLC CurrentSince Jun 21, 2020 Accepting new patients
Bold Freedom LLC PastSince Jun 14, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1639794035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 NW 111TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227826",
            "telephone_number": "954-826-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 NW 111TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227826",
            "telephone_number": "954-826-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "CALDON",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9536363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cpbarnes01@gmail.com",
            "affiliation": "Y",
            "affiliationName": "Bold Step, LLC",
            "address_1": "1121 NW 111th Ave",
            "city": "Plantation",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333227826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.