Individual provider Active NPI

Andrecile F Wancy, CNA

  • Home Health Aide
  • Delray Beach, FL
National Provider Identifier
1063075745
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
100 E Linton Blvd Ste 116B
Delray Beach, FL 33483-3341
Phone
(561) 420-6842
Fax
(561) 342-8995
NPI assigned
Apr 17, 2019
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X NU
Adult Companion 372600000X NU
Home Health Aide 374U00000X NU Primary
Homemaker 376J00000X NU
Nurse's Aide 376K00000X CNA90706 FL

Addresses

Primary practice location

100 E Linton Blvd Ste 116B
Delray Beach, FL 33483-3341

Mailing address

4739 Cambridge St
Lake Worth, FL 33463-2267
Phone (561) 531-4628

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
CNA90706FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1063075745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4739 CAMBRIDGE ST",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334632267",
            "telephone_number": "561-531-4628",
            "fax_number": "561-342-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LINTON BLVD STE 116B",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334833341",
            "telephone_number": "561-420-6842",
            "fax_number": "561-342-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANCY",
        "first_name": "ANDRECILE",
        "middle_name": "F",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "CNA90706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

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