1558829721 NPI number — MRS. RAVEN SHENETTE MAYES JAMES ONA/MD/ARNP

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558829721 NPI number — MRS. RAVEN SHENETTE MAYES JAMES ONA/MD/ARNP

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MAYES JAMES

Provider First Name:

RAVEN

Provider Middle Name:

SHENETTE

Provider Name Prefix Text:

MRS.

Provider Name Suffix Text:

Provider Credential Text:

ONA/MD/ARNP

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

MAYES

Provider Other First Name:

RAVEN

Provider Other Middle Name:

SHENETTE

Provider Other Name Prefix Text:

MISS

Provider Other Name Suffix Text:

Provider Other Credential Text:

ARNP/MD/ARNP

Provider Other Last Name Type Code:

2

NPI Number:

1558829721

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/21/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 2303

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

HAWTHORNE

Provider Business Mailing Address State Name:

FL

Provider Business Mailing Address Postal Code:

32640-2303

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

352-271-5000

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

2275 E MARIPOSA AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

EL SEGUNDO

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

90245-5029

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

310-426-6000

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

03/06/2019

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 103T00000X , with the licence number:  50-2560 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 152W00000X , with the licence number: ONA21898 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 156F00000X , with the licence number: CNA92737 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 171000000X , with the licence number: 7-0076 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 171000000X , with the licence number: 50-1454 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 172A00000X , with the licence number: M200-737-79-557-0 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207P00000X , with the licence number: 50-2560 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207U00000X , with the licence number: 50-2560 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261Q00000X , with the licence number: 50-4007 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 332100000X , with the licence number: 50-2560 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363L00000X , with the licence number: CEP15022 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363L00000X , with the licence number: ABNP1418 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363L00000X , with the licence number: FLAPN559215 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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• Identifier: 0215-2303 . This is a "PREGANANCY MANAGEMENT IN WOMEN WITH OBESITY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 0215-2303 . This is a "CATRACT & REFECTIVE 360 FUNDAMENTALS TECHNIQUES & TECHNOLOGY VOL. 3" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
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• Identifier: 20-227490 . This is a "WOUND CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 20-545977 . This is a "HEALTHCARE VIOLENCE: WHY PEERS BULLY PEERS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 20-574084 . This is a "FLORIDA LAWS NURSING" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 20-575182 . This is a "ETHICS AND LEGAL ISSUES IN NURSING" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
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