Active NPI
Ingrid M Thomas
- Home Health Agency
- Eustis, FL
National Provider Identifier
1124751847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Developmental Disabilities Clinic/Center | 261QD1600X | |||
| Adult Companion | 372600000X | |||
| Home Health Aide | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016930900 | Medicaid | FL |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Supports Services LLC | Home Health | Current | Accepting new patients |
| Thomas Supports Services LLC | Home Health | Current | 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.
-
- Home Health Agency
- Clermont, FL
- NPI 1578102836
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.