Nettie Mae Berry Foundation LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

NETTIE MAE BERRY FOUNDATION LLC

Practice address

901 NW 8TH Ave Ste A2
Gainesville, FL 32601-5000

Phone

(352) 258-3450

Fax

(352) 379-5502

NPI assigned

Oct 24, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Tandra Lamikia SimmonsNPI 1912345372

Title

Ceo

Phone

(352) 258-3450

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tandra Lamikia Simmons

  • Developmentally Disabled Services Day Training Agency
  • Gainesville, FL
  • NPI 1912345372

  Case Management

  NPD Authorized official

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1942927694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358774",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326358774",
            "telephone_number": "352-258-3450",
            "fax_number": "352-379-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NW 8TH AVE STE A2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326015000",
            "telephone_number": "352-258-3450",
            "fax_number": "352-379-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NETTIE MAE BERRY FOUNDATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "TANDRA",
        "authorized_official_middle_name": "LAMIKIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-258-3450",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan David Nesselroade, M.D.
• Richard Joseph Nessif, D. D. S.
• Dawn Nessler, PHD, LISW-CP, LCSW
• Nettie Mae Berry Foundation LLC
• Nettie Mae Berry Foundation LLC
• Nettie's Love & Care LLC
• Rachel E. Nettle, ARNP
• Debbie Nettles
• Shauna Nettles, APRN
• Ruthann Yoder Nettleton, PA-C

• Developmentally Disabled Services Day Training Agency in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.