Medsource, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

1980 Issued in FL

Legal business name

MEDSOURCE, LLC

Practice address

33 N Garden Ave Ste 800
Clearwater, FL 33755-6614

Phone

(800) 440-1909

Fax

(866) 206-2900

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Nancy Kraft

Title

Client Specialist

Phone

(800) 440-1909

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194897553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N GARDEN AVE STE 800",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337556614",
            "telephone_number": "800-440-1909",
            "fax_number": "866-206-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N GARDEN AVE STE 800",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337556614",
            "telephone_number": "800-440-1909",
            "fax_number": "866-206-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOURCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRAFT",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CLIENT SPECIALIST",
        "authorized_official_telephone_number": "800-440-1909"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "1980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.