NPIMap

Organization Active NPI

Shantell Foster

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Yulee, FL
National Provider Identifier
1770016347
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
SHANTELL FOSTER
Practice address
96159 Mount Zion Loop
Yulee, FL 32097-6332
Phone
(904) 753-3285
Fax
(904) 849-7124
NPI assigned
Apr 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Authorized official

Name
Mrs. Shantell FosterNPI 1962034744
Title
Owner
Phone
(904) 753-3285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X FL Primary

Addresses

Primary practice location

96159 Mount Zion Loop
Yulee, FL 32097-6332

Mailing address

96159 Mount Zion Loop
Yulee, FL 32097-6332
Phone (904) 753-3285

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1770016347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96159 MOUNT ZION LOOP",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976332",
            "telephone_number": "904-753-3285",
            "fax_number": "904-849-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96159 MOUNT ZION LOOP",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976332",
            "telephone_number": "904-753-3285",
            "fax_number": "904-849-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTELL FOSTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "SHANTELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-753-3285",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yulee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.