Individual provider Active NPI

Jarvin Vines

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Orlando, FL
National Provider Identifier
1164950929
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Practice address
7215 Jonquil Dr
Orlando, FL 32818-5808
Phone
(407) 305-1925
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X FL Primary
Physical Disabilities Residential Treatment Facility 320700000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X FL

Addresses

Primary practice location

7215 Jonquil Dr
Orlando, FL 32818-5808

Mailing address

7215 Jonquil Dr
Orlando, FL 32818-5808
Phone (407) 305-1925

Other identifiers 1

IdentifierTypeStateIssuer
670200MedicaidFL

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
Vines Home Care Solutions, Inc. Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities CurrentSince Jul 24, 2022 Accepting new patients
Champion Home Care Solutions, LLC CurrentSince Jul 28, 2024 Accepting new patients
Corecare Connections, LLC Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities PastSince Jul 28, 2024 Accepting new patients

Organizations & group practices 3

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1164950929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 JONQUIL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328185808",
            "telephone_number": "407-305-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 JONQUIL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328185808",
            "telephone_number": "407-305-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINES",
        "first_name": "JARVIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.