NPIMap

Organization Active NPI

Nursecore Management Services LLC

  • Home Health Agency
  • St Petersburg, FL
National Provider Identifier
1164522215
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
20790095 Issued in FL
Legal business name
NURSECORE MANAGEMENT SERVICES LLC
Practice address
1919 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone
(727) 345-7009
Fax
(727) 345-6393
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Deborah Lollar
Title
President/Ceo
Phone
(817) 649-1166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 20790095 FL Primary

Addresses

Primary practice location

1919 Tyrone Blvd N
St Petersburg, FL 33710-4841

Mailing address

PO Box 201925
Arlington, TX 76006-1925
Phone (817) 649-1166

Other identifiers 2

IdentifierTypeStateIssuer
H0WOtherFLBLUE CROSS BLUE SHIELD
115054200MedicaidFL

Other names 1

  • NURSECORE OF ST PETERSBURG Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1001915Nursecore of St Petersburg1919 Tyrone Blvd N, Saint Petersburg, FL 33710Certificate of waiverJul 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Nursecore Management Services LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1919 Tyrone Blvd N
St Petersburg, FL 33710
Phone (727) 345-7009

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1164522215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201925",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760061925",
            "telephone_number": "817-649-1166",
            "fax_number": "817-649-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-345-7009",
            "fax_number": "727-345-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSECORE MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "LOLLAR",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "817-649-1166"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "20790095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "H0W",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115054200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NURSECORE OF ST PETERSBURG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.