MEDICARE: JOHN SHAQUILLE POITIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1639035710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SHAQUILLE POITIER

Provider Business Mailing Address
First Line	:	1 HAYDEN DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-2520
Country	:	US
Telephone Number	:	434-637-3595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 HAYDEN DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-2520
Country	:	US
Telephone Number	:	434-637-3595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2026
Last Update Date	:	01/01/2026

Similar Medicare Providers

1003476219 — DEBRA SPICELY JONES
Practice Location Address:

1 HAYDEN DR
PETERSBURG, VA
23803-2520

Practice Phone: 804-524-5847
Practice Fax:

1194700385 — BETTY ANN HAVEY LMFT
Practice Location Address:

2520 EAST VINA DEL MAR BLVD
ST PETERSBURG BEACH, FL
33707

Practice Phone: 850-524-4090
Practice Fax:

1770593634 — DR. NATALIE N ELLIS M.D.
Practice Location Address:

DR. NATALIE ELLIS , 2520 CENTRAL AVE.
ST PETERSBURG, FL
33712-1862

Practice Phone: 727-203-4207
Practice Fax:

1942359070 — ACUPUNCTURE & HERBAL THERAPIES
Practice Location Address:

2520 CENTRAL AVE.
ST. PETERSBURG, FL
33712

Practice Phone: 727-551-0857
Practice Fax: 727-202-6896

1366565228 — MR. VALENTIN MIREA A.P., D.O.M.
Practice Location Address:

2520 CENTRAL AVE.
ST. PETERSBURG, FL
33712

Practice Phone: 727-551-0857
Practice Fax: 727-202-6896

1134473895 — MR. ROBERT GREGORY LINDE A.P., D.O.M.
Practice Location Address:

2520 CENTRAL AVE.
ST. PETERSBURG, FL
33712

Practice Phone: 727-551-0857
Practice Fax: 727-202-6896

Directions to “ JOHN SHAQUILLE POITIER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.