Active NPI
Angels Over Elders LLC
- Home Health Agency
- Jacksonville, FL
National Provider Identifier
1104165471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ANGELS OVER ELDERS LLC
- Practice address
- 3601 Kernan Blvd S Apt 934
Jacksonville, FL 32224-9690 - Phone
- (904) 994-2914
- NPI assigned
- Feb 6, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Latoya Butler
- Title
- Owner
- Phone
- (904) 994-2914
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | FL | Primary |
Addresses
Primary practice location
3601 Kernan Blvd S Apt 934
Jacksonville, FL 32224-9690
Mailing address
3601 Kernan Blvd S Apt 934
Jacksonville, FL 32224-9690
Phone (904) 994-2914
Other practice location 1
5710 Lenox Ave
#121
Jacksonville, FL 32205-6382
Phone (904) 994-2914
Other practice location 2
3601 Kernan Blvd S Apt 934
Jacksonville, FL 32224-9690
Phone (904) 994-2914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105045700 | Medicaid | FL |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663718400000",
"number": "1104165471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 KERNAN BLVD S APT 934",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322249690",
"telephone_number": "904-994-2914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 KERNAN BLVD S APT 934",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322249690",
"telephone_number": "904-994-2914"
}
],
"practiceLocations": [
{
"address_1": "5710 Lenox Ave",
"address_2": "#121",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322056382",
"country_code": "US",
"telephone_number": "904-994-2914",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 Kernan Blvd S Apt 934",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322249690",
"country_code": "US",
"telephone_number": "904-994-2914",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ANGELS OVER ELDERS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-06",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A",
"authorized_official_last_name": "BUTLER",
"authorized_official_first_name": "LATOYA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "904-994-2914"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105045700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.