Kalisha Shevoin Jefferson

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

CNA23616 Issued in FL

Practice address

565 Herbert St
Saint Augustine, FL 32084-4074

Phone

(904) 466-8993

NPI assigned

Feb 8, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1982169330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 HERBERT ST",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844074",
            "telephone_number": "904-466-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 HERBERT ST",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844074",
            "telephone_number": "904-466-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "KALISHA",
        "middle_name": "SHEVOIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "CNA23616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "831531406",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kumait Jaroje, M.D.
• Jason Jones
• Jax Family Health Clinic PLLC
• Paul David Jayachandra, M D P A
• Michael Stanley Jecen, PA
• Matthew Joseph Jeffs, PT
• Barbara Jenkin, MA,CAP
• Allison Jenkins
• James Louis Jenkins, LMHC
• Katherine M Jennison, RD LDN

• Home Health Agency in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.