Primary Care in Your Home LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ARNP3333802 Issued in FL

Legal business name

PRIMARY CARE IN YOUR HOME LLC

Practice address

341 W Minnesota Ave
Orange City, FL 32763-2205

Phone

(386) 316-5439

NPI assigned

Sep 30, 2012

Last updated

Oct 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Croker, ARNP

Title

Owner/Manager

Phone

(386) 316-5439

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy D Jetton, M.D.

  • Family Medicine Physician
  • The Villages, FL
  • NPI 1295708139
  NPD (past)

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

{
    "created_epoch": "1348963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1003167073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 W MINNESOTA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327632205",
            "telephone_number": "386-316-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 W MINNESOTA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327632205",
            "telephone_number": "386-316-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE IN YOUR HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-30",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "CROKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "386-316-5439",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ARNP3333802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305918900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Prado
• PRC Associates LLC
• Precision Home Care Agency Inc.
• Preferred Injury Physicians of Orange City
• Amber Presa-Smalley
• Primary Care of Oc LLC
• Primary Care of Orange City LLC
• Primary Care of Orange City LLC (Home Wound Care Florida)
• Gregory Wade Prince, ARNP, FNP-C
• Alyssa Proenza

• Primary Care Clinic/Center in Orange City, FL
• Providers in Orange City, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.