Organization Active NPI

Siragusa LLC Dba Granny Nannies

  • Home Health Agency
  • Tampa, FL
National Provider Identifier
1104291624
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
30211147 Issued in FL
Legal business name
SIRAGUSA LLC DBA GRANNY NANNIES
Practice address
3902 Henderson Blvd
Suite 200
Tampa, FL 33629-5038
Phone
(813) 254-1299
Fax
(813) 877-6385
NPI assigned
Dec 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Ms. Jodi Earle
Title
Director of Operations
Phone
(813) 254-1299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 30211147 FL Primary

Addresses

Primary practice location

3902 Henderson Blvd
Suite 200
Tampa, FL 33629-5038

Mailing address

3902 Henderson Blvd
Suite 200
Tampa, FL 33629-5038
Phone (813) 254-1299

Other identifiers 1

IdentifierTypeStateIssuer
684866401MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Siragusa LLC Dba Granny Nannies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3902 Henderson Blvd
Ste 200
Tampa, FL 33629
Phone (800) 277-1182

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1104291624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 HENDERSON BLVD",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295038",
            "telephone_number": "813-254-1299",
            "fax_number": "813-877-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 HENDERSON BLVD",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295038",
            "telephone_number": "813-254-1299",
            "fax_number": "813-877-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIRAGUSA LLC DBA GRANNY NANNIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "EARLE",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "813-254-1299",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "30211147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "684866401",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.