Individual provider Active NPI

Patricia Williams

  • Home Health Agency
  • Port St Lucie, FL
National Provider Identifier
1053762294
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299994478 Issued in FL
Practice address
439 SE Port St Lucie Blvd Ste 117
Port St Lucie, FL 34984-5158
Phone
(772) 201-8128
Fax
(772) 785-9190
NPI assigned
Jun 29, 2016
Last updated
Oct 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299994478 FL Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

439 SE Port St Lucie Blvd Ste 117
Port St Lucie, FL 34984-5158

Mailing address

3364 SW Crestview Rd
Port St Lucie, FL 34953-3538
Phone (772) 201-8128

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

LicenseStateTypeSpecialty
299994478FLMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Allcare Health & Human Services, Inc Home Health CurrentSince Oct 20, 2019 Accepting new patients

Locations

439 SE Port St Lucie Blvd
Ste 117
Port St Lucie, FL 34984
Phone (772) 201-8128

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1053762294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3364 SW CRESTVIEW RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349533538",
            "telephone_number": "772-201-8128",
            "fax_number": "772-785-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 SE PORT ST LUCIE BLVD STE 117",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845158",
            "telephone_number": "772-201-8128",
            "fax_number": "772-785-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299994478",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.