Active NPI
Patricia Harrell
- Health & Wellness Coach
- St. Augustine, FL
National Provider Identifier
1952027435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- 574897240
- Practice address
- 1168 Carmona Place
St. Augustine, FL 32092 - Phone
- (904) 859-6294
- NPI assigned
- Oct 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | 574897240 | FL | Primary |
Addresses
Primary practice location
1168 Carmona Place
St. Augustine, FL 32092
Mailing address
1168 Carmona Place
St. Augustine, FL 32092
Phone (904) 859-6294
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
| License | State | Type | Specialty |
|---|---|---|---|
| 574897240 | FL | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1952027435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1168 CARMONA PLACE",
"city": "ST. AUGUSTINE",
"state": "FL",
"postal_code": "32092",
"telephone_number": "904-859-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1168 CARMONA PLACE",
"city": "ST. AUGUSTINE",
"state": "FL",
"postal_code": "32092",
"telephone_number": "904-859-6294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "PATRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-17",
"last_updated": "2022-10-17",
"certification_date": "2022-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "FL",
"license": "574897240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.