Individual provider Active NPI

Winifried McCalla

  • Nurse's Aide
  • Lakeland, FL
National Provider Identifier
1659734515
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
102424 Issued in FL
Practice address
1104 Bartow Rd # H85
Lakeland, FL 33801-5850
Phone
(863) 812-7724
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 102424 FL Primary

Addresses

Primary practice location

1104 Bartow Rd # H85
Lakeland, FL 33801-5850

Mailing address

1104 Bartow Rd # H85
Lakeland, FL 33801-5850
Phone (863) 812-7724

Other identifiers 1

IdentifierTypeStateIssuer
010465800MedicaidFL

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

LicenseStateTypeSpecialty
102424FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1659734515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 BARTOW RD # H85",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015850",
            "telephone_number": "863-812-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 BARTOW RD # H85",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015850",
            "telephone_number": "863-812-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLA",
        "first_name": "WINIFRIED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "102424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010465800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.

Verify at the official NPI Registry.