Individual provider Active NPI

Shawn Latrice Hair

  • In Home Supportive Care Agency
  • Orlando, FL
National Provider Identifier
1811671282
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
87-0835223 Issued in FL
Practice address
3960 W.D. Judge .Dr.Apt138
3960 W D Judge Dr.Apt138
Orlando, FL 32808
Phone
(132) 159-4382
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 87-0835223 FL Primary

Addresses

Primary practice location

3960 W.D. Judge .Dr.Apt138
3960 W D Judge Dr.Apt138
Orlando, FL 32808

Mailing address

3241 Old Winter Garden Rd Ste 26
Orlando, FL 32805-1124
Phone (321) 594-3829

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
87-0835223FLMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1811671282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 OLD WINTER GARDEN RD STE 26",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051124",
            "telephone_number": "321-594-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 W.D. JUDGE .DR.APT138",
            "address_2": "3960 W D JUDGE DR.APT138",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32808",
            "telephone_number": "132-159-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIR",
        "first_name": "SHAWN",
        "middle_name": "LATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "87-0835223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.