Active NPI
Johnny Camille
- Home Health Agency
- Winter Haven, FL
National Provider Identifier
1023795622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 238688
- Practice address
- 2450 Bates Ave SW
Winter Haven, FL 33880-2448 - Phone
- (863) 877-6041
- NPI assigned
- Jul 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 238688 | FL | |
| Home Health Agency | 251E00000X | 238688 | FL | Primary |
Addresses
Primary practice location
2450 Bates Ave SW
Winter Haven, FL 33880-2448
Mailing address
2450 Bates Ave SW
Winter Haven, FL 33880-2448
Phone (863) 877-6041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238688 | FL | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1023795622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 BATES AVE SW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338802448",
"telephone_number": "863-877-6041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 BATES AVE SW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338802448",
"telephone_number": "863-877-6041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMILLE",
"first_name": "JOHNNY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-05",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "FL",
"license": "238688",
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "FL",
"license": "238688",
"primary": true
}
],
"identifiers": [],
"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 Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.