Sep Companion Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SEP COMPANION SERVICES

Practice address

1979 Lane Ave S
Jacksonville, FL 32210-2741

Phone

(904) 610-9525

NPI assigned

Oct 14, 2020

Organization subpart

No

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

Authorized official

Name

Lesly Dervil

Title

Owner

Phone

(904) 610-9525

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114525821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1979 LANE AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102741",
            "telephone_number": "904-610-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 LANE AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102741",
            "telephone_number": "904-610-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEP COMPANION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2025-09-11",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "DERVIL",
        "authorized_official_first_name": "LESLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-610-9525"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOMEMAKER & COMPANION",
            "identifier": "HOMEMAKER",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253Z00000X",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "address_1": "1979 Lane Ave S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322102741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.