Individual provider Active NPI

Charlene Marie Calvert, LPN

  • Licensed Practical Nurse
  • Havana, FL
National Provider Identifier
1740722719
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5207537 Issued in FL
Practice address
135 Hawk Ridge Dr
Havana, FL 32333-4145
Phone
(850) 539-0283
NPI assigned
Nov 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5207537 FL Primary

Addresses

Primary practice location

135 Hawk Ridge Dr
Havana, FL 32333-4145

Mailing address

135 Hawk Ridge Dr
Havana, FL 32333-4145
Phone (850) 539-0283

Other names 1

  • Mrs. Charlene Marie Henderson Former name

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
PN5207537FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1740722719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 HAWK RIDGE DR",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323334145",
            "telephone_number": "850-539-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 HAWK RIDGE DR",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323334145",
            "telephone_number": "850-539-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVERT",
        "first_name": "CHARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5207537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLENE",
            "last_name": "HENDERSON",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Havana, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.