Individual provider Active NPI

Sherika Mack

  • Day Training/Habilitation Specialist
  • Gainesville, FL
National Provider Identifier
1881349314
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
License
104017500 Issued in FL
Practice address
6921 NW 22ND St
Gainesville, FL 32653-1228
Phone
(352) 554-5231
NPI assigned
Feb 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X 104017500 FL Primary

Addresses

Primary practice location

6921 NW 22ND St
Gainesville, FL 32653-1228

Mailing address

5758 NW 63Rd PL
Ocala, FL 34482-7657
Phone (352) 301-0642

Other practice location 1

5758 NW 63rd Pl
Ocala, FL 34482-7657
Phone (352) 301-0642

Other identifiers 3

IdentifierTypeStateIssuer
320900000XOtherFLHOME AND COMMUNITY BASED SERVICES WAIVER
104017500MedicaidFL
320900000XMedicaidFL

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
104017500FLMDDay Training/Habilitation Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Solar Nursing & Care LLC CurrentSince Feb 24, 2022 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": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1881349314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5758 NW 63RD PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344827657",
            "telephone_number": "352-301-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6921 NW 22ND ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326531228",
            "telephone_number": "352-554-5231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5758 NW 63rd Pl",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344827657",
            "country_code": "US",
            "telephone_number": "352-301-0642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "SHERIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "FL",
            "license": "104017500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME AND COMMUNITY BASED SERVICES WAIVER",
            "identifier": "320900000X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104017500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320900000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.