Individual provider Active NPI

Lequita Michelle Wiggins

  • Registered Nurse
  • Jacksonville, FL
National Provider Identifier
1710667399
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9561258 Issued in FL
Practice address
4472 Misty Dawn CT S
Jacksonville, FL 32277-1388
Phone
(706) 315-7863
NPI assigned
Jul 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9561258 FL Primary
Home Health Aide 374U00000X

Addresses

Primary practice location

4472 Misty Dawn CT S
Jacksonville, FL 32277-1388

Mailing address

4472 Misty Dawn CT S
Jacksonville, FL 32277-1388
Phone (706) 315-7863

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
RN9561258FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Compassion in Action Home Care Services LLC CurrentSince Jul 23, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1710667399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4472 MISTY DAWN CT S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771388",
            "telephone_number": "706-315-7863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4472 MISTY DAWN CT S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771388",
            "telephone_number": "706-315-7863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "LEQUITA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9561258",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 24, 2023; 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.