Innovative Support Services, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INNOVATIVE SUPPORT SERVICES, LLC

Practice address

310 Modest St
Lakeland, FL 33805-3123

Phone

(863) 904-8820

Fax

(866) 271-5349

NPI assigned

Mar 18, 2011

Organization subpart

No

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

Authorized official

Name

Stephanie Kirnes, MA, CMHP

Title

Executive Director

Phone

(863) 904-8820

Specialties & licenses 5

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Veronica Kirnes Rountree

  • Community Health Worker
  • Lakeland, FL
  • NPI 1013226109
  NPD (past)

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1184923054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2253",
            "city": "EATON PARK",
            "state": "FL",
            "postal_code": "338402253",
            "telephone_number": "863-904-8820",
            "fax_number": "866-271-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MODEST ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053123",
            "telephone_number": "863-904-8820",
            "fax_number": "866-271-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "KIRNES",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "863-904-8820",
        "authorized_official_credential": "MA, CMHP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Lakeland, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.