Individual provider Active NPI

Shontal Monique Taite, LPN

  • Licensed Practical Nurse
  • Mobile, AL
National Provider Identifier
1992049738
Registry record updated Nov 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2060489 Issued in AL
Practice address
4518 Schimpfs LN
Mobile, AL 36619-1622
Phone
(251) 661-0612
Fax
(251) 661-0612
NPI assigned
Nov 17, 2012
Last updated
Nov 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2012

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2060489 AL Primary
Licensed Practical Nurse 164W00000X PN5204157 FL
Licensed Vocational Nurse 164X00000X PN5204157 FL
Licensed Vocational Nurse 164X00000X 2060489 AL
Driver 172A00000X
Chore Provider 372500000X
Adult Companion 372600000X
Technician 374700000X
Attendant Care Provider 3747A0650X
Personal Care Attendant 3747P1801X
Religious Nonmedical Nursing Personnel 374T00000X
Home Health Aide 374U00000X
Homemaker 376J00000X
Nurse's Aide 376K00000X

Addresses

Primary practice location

4518 Schimpfs LN
Mobile, AL 36619-1622

Mailing address

4518 Schimpfs LN
Mobile, AL 36619-1622
Phone (251) 661-0612

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
PN5204157FLMDLicensed Practical Nurse
2060489ALMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1353110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353110400000",
    "number": "1992049738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 SCHIMPFS LN",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366191622",
            "telephone_number": "251-661-0612",
            "fax_number": "251-661-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 SCHIMPFS LN",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366191622",
            "telephone_number": "251-661-0612",
            "fax_number": "251-661-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAITE",
        "first_name": "SHONTAL",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-17",
        "last_updated": "2012-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AL",
            "license": "2060489",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5204157",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "FL",
            "license": "PN5204157",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "AL",
            "license": "2060489",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374T00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Nursing Personnel",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2012; 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.