Individual provider Active NPI

Willa Mae Floyd, RN

  • School Registered Nurse
  • Lake City, SC
National Provider Identifier
1659717643
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
43831 Issued in SC
Practice address
906 N Matthews Rd
Lake City, SC 29560-7011
Phone
(843) 374-2353
Fax
(843) 374-5480
NPI assigned
May 16, 2013
Last updated
May 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 43831 SC Primary

Addresses

Primary practice location

906 N Matthews Rd
Lake City, SC 29560-7011

Mailing address

233 N Floyd Rd
Scranton, SC 29591-5578
Phone (843) 659-4350

Other identifiers 1

IdentifierTypeStateIssuer
1245288901MedicaidSC

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
43831SCMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1659717643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 N FLOYD RD",
            "city": "SCRANTON",
            "state": "SC",
            "postal_code": "295915578",
            "telephone_number": "843-659-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N MATTHEWS RD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295607011",
            "telephone_number": "843-374-2353",
            "fax_number": "843-374-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "WILLA",
        "middle_name": "MAE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "SC",
            "license": "43831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245288901",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.