NPIMap

Organization Active NPI

Community Aging & Retirement Services, Inc

  • Adult Day Care Clinic/Center
  • Brandon, FL
National Provider Identifier
1063803880
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
9288 Issued in FL
Legal business name
COMMUNITY AGING & RETIREMENT SERVICES, INC
Practice address
3940 Canoga Park Dr
Brandon, FL 33511
Phone
(813) 330-7964
NPI assigned
Feb 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Authorized official

Name
William Aycrigg
Title
Chief Executive Officer
Phone
(727) 862-9291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 9288 FL Primary

Addresses

Primary practice location

3940 Canoga Park Dr
Brandon, FL 33511

Mailing address

12417 Clock Tower Pkwy
Hudson, FL 34667-2411
Phone (727) 862-9291

Other identifiers 1

IdentifierTypeStateIssuer
00000000OtherAPPLYING FOR MEDICAID NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Community Aging Retirement Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

12417 Clock Tower Pkwy
Hudson, FL 34667
Phone (727) 862-9291

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1063803880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 CLOCK TOWER PKWY",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346672411",
            "telephone_number": "727-862-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 CANOGA PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-330-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY AGING & RETIREMENT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "AYCRIGG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "727-862-9291"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": "9288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLYING FOR MEDICAID NUMBER",
            "identifier": "00000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.