Shanace Isaac, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5252077 Issued in FL

Practice address

629 Daniels St
Hastings, FL 32145-3201

Phone

(904) 293-5395

NPI assigned

Mar 28, 2022

Sex

Female

Sole proprietor

Yes

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.

• Addlife Care Connection, LLC

  • Licensed Practical Nurse
  • Hastings, FL
  • NPI 1629719729
  NPD Authorized official LICENSED PRACTICAL NURSE

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2022.

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1902556103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101",
            "city": "HASTINGS",
            "state": "FL",
            "postal_code": "321450101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 DANIELS ST",
            "city": "HASTINGS",
            "state": "FL",
            "postal_code": "321453201",
            "telephone_number": "904-293-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAAC",
        "first_name": "SHANACE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5252077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard William Coleman
• Annette Diko
• G4S Youth Services, LLC
• Heart2Heart Clinic & Infusion PLLC
• Inbound Foundation, Inc.
• Michelle Kessler, FNP-BC
• Pamela Sue Marciszewski, LPN
• Mark Casey Phillips
• Matthew David Masters
• Samantha Lynn Milstead

• All providers in Hastings, FL
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.