Nettie Mae Berry Foundation LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

689678298 Issued in FL

Legal business name

NETTIE MAE BERRY FOUNDATION LLC

Practice address

113 NE 39TH PL
Gainesville, FL 32609-1717

Phone

(352) 258-3450

Fax

(352) 376-5474

NPI assigned

Jun 25, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Tandra Laimikia Simmons

Title

Owner

Phone

(352) 258-3450

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Nettie Mae Berry Foundation LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nettie Mae Berry Foundation LLC

  • Developmentally Disabled Services Day Training Agency
  • Gainesville, FL
  • NPI 1295993665
  NPD tax ID

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1679734396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 NE 39TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326091717",
            "telephone_number": "352-258-3450",
            "fax_number": "352-376-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 NE 39TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326091717",
            "telephone_number": "352-258-3450",
            "fax_number": "352-376-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NETTIE MAE BERRY FOUNDATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "TANDRA",
        "authorized_official_middle_name": "LAIMIKIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-258-3450",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "689678298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689678298",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard L Nesmith, MD DMD
• Ryan David Nesselroade, M.D.
• Richard Joseph Nessif, D. D. S.
• Dawn Nessler, PHD, LISW-CP, LCSW
• Nettie Mae Berry Foundation LLC
• Nettie Mae Berry Foundation LLC
• Nettie'S Love & Care LLC
• Rachel E. Nettle, ARNP
• Debbie Nettles
• Shauna Nettles, APRN

• Developmentally Disabled Services Day Training Agency in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.