Individual provider Active NPI

Lashonda Grant, C.N.A

  • Nurse's Aide
  • Jacksonville, FL
National Provider Identifier
1679850168
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
123348 Issued in FL
Practice address
2134 Bo Peep Dr W
Jacksonville, FL 32210-2918
Phone
(904) 476-9743
Fax
(904) 786-9759
NPI assigned
Nov 10, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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 123348 FL Primary

Addresses

Primary practice location

2134 Bo Peep Dr W
Jacksonville, FL 32210-2918

Mailing address

2134 Bo Peep Dr W
Jacksonville, FL 32210-2918
Phone (904) 476-9743

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
123348FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1679850168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 BO PEEP DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102918",
            "telephone_number": "904-476-9743",
            "fax_number": "904-786-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 BO PEEP DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102918",
            "telephone_number": "904-476-9743",
            "fax_number": "904-786-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "LASHONDA",
        "credential": "C.N.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "123348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.