Individual provider Active NPI

Ingrid M Thomas

  • Home Health Agency
  • Eustis, FL
National Provider Identifier
1124751847
Registry record updated Jul 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
15 E Magnolia Ave Ste 3B
Eustis, FL 32726-3472
Phone
(352) 617-0777
Fax
(352) 251-1911
NPI assigned
Jul 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X
Developmental Disabilities Clinic/Center 261QD1600X
Adult Companion 372600000X
Home Health AideGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 374U00000X
Homemaker 376J00000X
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

15 E Magnolia Ave Ste 3B
Eustis, FL 32726-3472

Mailing address

15 E Magnolia Ave Ste 3B
Eustis, FL 32726-3472
Phone (352) 617-0777

Other identifiers 1

IdentifierTypeStateIssuer
016930900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Supports Services LLC Home Health CurrentSince Jul 16, 2023 Accepting new patients
Thomas Supports Services LLC Home Health CurrentSince Jul 17, 2022 Accepting new patients

Locations

15 E Magnolia Ave
Ste 3B
Eustis, FL 32726
Phone (352) 617-0777

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1124751847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E MAGNOLIA AVE STE 3B",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327263472",
            "telephone_number": "352-617-0777",
            "fax_number": "352-251-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E MAGNOLIA AVE STE 3B",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327263472",
            "telephone_number": "352-617-0777",
            "fax_number": "352-251-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "INGRID",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-09",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016930900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

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