Populus Primus LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

POPULUS PRIMUS LLC

Practice address

14523 Callen Glen Way
Wimauma, FL 33598-6179

Phone

(727) 226-2196

NPI assigned

Jan 3, 2025

Organization subpart

No

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

Authorized official

Name

Tanisha Foster

Title

Owner

Phone

(727) 226-2196

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1003625112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14523 CALLEN GLEN WAY",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335986179",
            "telephone_number": "727-226-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14523 CALLEN GLEN WAY",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335986179",
            "telephone_number": "727-226-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPULUS PRIMUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "TANISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-226-2196"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wimauma, FL
• Providers in Wimauma, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.