Individual provider Active NPI

Lakisha F Williams-Noukhal, APRN

Nurse Practitioner
Ruskin, FL

National Provider Identifier

1700438066

Registry record updated Jul 16, 2019

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Ruskin, FL
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Nurse PractitionerTaxonomy code 363L00000X
License: 11003056 Issued in FL
Practice address: 2260 Roanoke Springs Dr
Ruskin, FL 33570-6314
Phone: (727) 644-3191
NPI assigned: Jul 16, 2019
Sex: Female
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Nurse Practitioner	363L00000X	11003056	FL	Primary

Addresses

Primary practice location

2260 Roanoke Springs Dr
Ruskin, FL 33570-6314

Mailing address

PO Box 1141
Ruskin, FL 33575-1141
Phone (727) 644-3191

Other identifiers 2

Identifier	Type	State	Issuer
APRN11003056	Medicaid	FL
APRN11003056	Other	FL	MEDICAID

Electronic endpoints 6

Type	Endpoint	Use
CONNECT URL	RUSKIN	Direct
CONNECT URL	RUSKIN	Health Information Exchange (HIE)
CONNECT URL	RUSKIN	Other
CONNECT URL	RUSKIN	Direct
CONNECT URL	RUSKIN	Health Information Exchange (HIE)
CONNECT URL	RUSKIN	Other

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled

State licenses

License	State	Type	Specialty
11003056	FL	MD	Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1700438066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1141",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335751141",
            "telephone_number": "727-644-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 ROANOKE SPRINGS DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335706314",
            "telephone_number": "727-644-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-NOUKHAL",
        "first_name": "LAKISHA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11003056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APRN11003056",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "APRN11003056",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RUSKIN",
            "affiliation": "N",
            "endpointDescription": "Home Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2260 Roanoke Springs Dr",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RUSKIN",
            "affiliation": "N",
            "endpointDescription": "Home address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2260 Roanoke Springs Dr",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RUSKIN",
            "affiliation": "N",
            "endpointDescription": "Home address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "RUSKIN",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2260 Roanoke Springs Dr",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RUSKIN",
            "affiliation": "N",
            "endpointDescription": "Home Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2260 Roanoke Springs Dr",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RUSKIN",
            "affiliation": "N",
            "endpointDescription": "Home address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2260 Roanoke Springs Dr",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RUSKIN",
            "affiliation": "N",
            "endpointDescription": "Home address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "RUSKIN",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2260 Roanoke Springs Dr",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ruskin, FL

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.