NPIMap

Organization Active NPI

Creator Original Services Inc

  • In Home Supportive Care Agency
  • Orlando, FL
National Provider Identifier
1053708735
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
230911 Issued in FL
Legal business name
CREATOR ORIGINAL SERVICES INC
Practice address
6828 Pomeroy Cir
Orlando, FL 32810-6575
Phone
(321) 299-6563
Fax
(407) 641-8693
NPI assigned
Apr 21, 2015
Last updated
Apr 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Audrey R Richards
Title
President
Phone
(321) 299-6563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 230911 FL Primary

Addresses

Primary practice location

6828 Pomeroy Cir
Orlando, FL 32810-6575

Mailing address

6828 Pomeroy Cir
Orlando, FL 32810-6575
Phone (321) 299-6563

Other identifiers 1

IdentifierTypeStateIssuer
230911OtherFLAGENCY FOR HEALTH CARE ADMINISTRATION

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1053708735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 POMEROY CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328106575",
            "telephone_number": "321-299-6563",
            "fax_number": "407-641-8693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6828 POMEROY CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328106575",
            "telephone_number": "321-299-6563",
            "fax_number": "407-641-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATOR ORIGINAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-299-6563"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "230911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY FOR HEALTH CARE ADMINISTRATION",
            "identifier": "230911",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.