Individual provider Active NPI

Linda R Siplin-Kerrin

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jacksonville, FL
National Provider Identifier
1942866611
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Practice address
11855 Alexandra Dr
Jacksonville, FL 32218-8878
Phone
(904) 616-2727
Fax
(904) 503-7465
NPI assigned
May 17, 2019
Last updated
May 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

11855 Alexandra Dr
Jacksonville, FL 32218-8878

Mailing address

11855 Alexandra Dr
Jacksonville, FL 32218-8878
Phone (904) 616-2727

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

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1942866611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11855 ALEXANDRA DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188878",
            "telephone_number": "904-616-2727",
            "fax_number": "904-503-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 ALEXANDRA DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188878",
            "telephone_number": "904-616-2727",
            "fax_number": "904-503-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPLIN-KERRIN",
        "first_name": "LINDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.