4CS Health LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

4CS HEALTH LLC

Practice address

1317 Edgewater Dr Ste 399
Orlando, FL 32804-6350

Phone

(813) 357-4546

Fax

(813) 946-9596

NPI assigned

Mar 10, 2021

Last updated

May 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shanisha Calloway Kirk

Title

Ceo

Phone

(813) 357-4546

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1851976997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DR STE 399",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046350",
            "fax_number": "813-946-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DR STE 399",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046350",
            "telephone_number": "813-357-4546",
            "fax_number": "813-946-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4CS HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "SHANISHA",
        "authorized_official_middle_name": "CALLOWAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-357-4546"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.