Organization Active NPI

J&T Divine Care

  • Attendant Care Provider
  • Mount Dora, FL
National Provider Identifier
1043966476
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Legal business name
J&T DIVINE CARE
Practice address
440 Royellou LN Ste 205
Mount Dora, FL 32757-5520
Phone
(407) 756-9492
NPI assigned
Feb 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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

Authorized official

Name
Tesica Barnes
Title
Administrator
Phone
(407) 756-9982

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Attendant Care ProviderGroup: 193200000X MULTI-SPECIALTY GROUP 3747A0650X Primary

Addresses

Primary practice location

440 Royellou LN Ste 205
Mount Dora, FL 32757-5520

Mailing address

440 Royellou LN Ste 205
Mount Dora, FL 32757-5520
Phone (407) 756-9492

Other identifiers 1

IdentifierTypeStateIssuer
109695900MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
JT Divine Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

440 Royellou Ln
Ste 205
Mount Dora, FL 32757
Phone (407) 756-9492

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647734400000",
    "number": "1043966476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 ROYELLOU LN STE 205",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327575520",
            "telephone_number": "407-756-9492",
            "fax_number": "352-729-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 ROYELLOU LN STE 205",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327575520",
            "telephone_number": "407-756-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&T DIVINE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "TESICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-756-9982"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109695900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; 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.