NPIMap

Organization Active NPI

Gena Obry

  • Adult Care Home Facility
  • Winter Haven, FL
National Provider Identifier
1023410545
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
6906588 Issued in FL
Legal business name
GENA OBRY
Practice address
439 Avenue D SE
Winter Haven, FL 33880-3531
Phone
(863) 229-5419
NPI assigned
Sep 17, 2014
Last updated
Sep 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Authorized official

Name
Gena ObryNPI 1740684554
Title
Owner
Phone
(863) 229-5419

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 6906588 FL Primary

Addresses

Primary practice location

439 Avenue D SE
Winter Haven, FL 33880-3531

Mailing address

439 Avenue D SE
Winter Haven, FL 33880-3531
Phone (863) 229-5419

Other identifiers 1

IdentifierTypeStateIssuer
012306000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Gena Obry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1023410545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 AVENUE D SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803531",
            "telephone_number": "863-229-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 AVENUE D SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803531",
            "telephone_number": "863-229-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENA OBRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "OBRY",
        "authorized_official_first_name": "GENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-229-5419"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012306000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.