Organization Active NPI

Vip America of Southwest Florida, LLC

  • Attendant Care Provider
  • Fort Myers, FL
National Provider Identifier
1104143486
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Legal business name
VIP AMERICA OF SOUTHWEST FLORIDA, LLC
Practice address
14440 Metropolis Ave Ste 103
Fort Myers, FL 33912-4364
Phone
(239) 690-9969
Fax
(239) 690-9971
NPI assigned
Apr 27, 2010
Organization subpart
Yes
Parent organization
VIP AMERICA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Ashley Skipper
Title
VP of Operations
Phone
(772) 220-6005

Specialties & licenses 1

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

Addresses

Primary practice location

14440 Metropolis Ave Ste 103
Fort Myers, FL 33912-4364

Mailing address

2500 S Kanner Hwy Ste 3
Stuart, FL 34994-4600
Phone (772) 220-6005

Other identifiers 1

IdentifierTypeStateIssuer
114309400MedicaidFL

National Provider Directory

National Provider Directory
Part of
Vip America LLC

Locations

14421 Metropolis Ave
Ste 104
Fort Myers, FL 33912
Phone (239) 470-7626

14440 Metropolis Ave
Ste 103
Fort Myers, FL 33912
Phone (239) 690-9969

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1104143486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S KANNER HWY STE 3",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944600",
            "telephone_number": "772-220-6005",
            "fax_number": "772-220-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 METROPOLIS AVE STE 103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124364",
            "telephone_number": "239-690-9969",
            "fax_number": "239-690-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP AMERICA OF SOUTHWEST FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIP AMERICA, LLC",
        "enumeration_date": "2010-04-27",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "SKIPPER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "772-220-6005"
    },
    "taxonomies": [
        {
            "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": "114309400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.