Individual provider Active NPI

Joelle Vanessa Archibal, RN-BSN

  • Home Health Registered Nurse
  • Lake Worth, FL
National Provider Identifier
1942774971
Registry record updated Jan 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN9477621 Issued in FL
Practice address
4656 Villas Santorini Dr
Lake Worth, FL 33461-5098
Phone
(561) 530-9686
NPI assigned
Jan 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WH0200X RN9477621 FL Primary

Addresses

Primary practice location

4656 Villas Santorini Dr
Lake Worth, FL 33461-5098

Mailing address

PO Box 541801
Greenacres, FL 33454-1801
Phone (561) 530-9686

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
RN9477621FLMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1547251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547251200000",
    "number": "1942774971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541801",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334541801",
            "telephone_number": "561-530-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 VILLAS SANTORINI DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334615098",
            "telephone_number": "561-530-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBAL",
        "first_name": "JOELLE",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "RN-BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-12",
        "last_updated": "2019-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "FL",
            "license": "RN9477621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2019; 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.