Organization Active NPI

Angels Over Elders LLC

  • Home Health Agency
  • Jacksonville, FL
National Provider Identifier
1104165471
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Sep 21, 2022

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
105045700MedicaidFL

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.