NPIMap

Organization Active NPI

Gulf Coast Village Home Health

  • Home Health Agency
  • Cape Coral, FL
National Provider Identifier
1215938535
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA29991969 Issued in FL
Legal business name
GULF COAST VILLAGE HOME HEALTH
Practice address
1435 Santa Barbara Blvd Ste 1
Cape Coral, FL 33991-2842
Phone
(239) 772-7480
Fax
(239) 772-7980
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Sarah Ruth Smith, RN
Title
Dir. of Home & Comm Based Services
Phone
(239) 772-7480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA29991969 FL Primary

Addresses

Primary practice location

1435 Santa Barbara Blvd Ste 1
Cape Coral, FL 33991-2842

Mailing address

1435 Santa Barbara Blvd Ste 1
Cape Coral, FL 33991-2842
Phone (239) 772-7480

Other names 1

  • Home Health by Gulf Coast Village Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061116000092 FL Part A Provider - Home Health Agency 9032117692 Practice locations: Cape Coral, FL

Home health agency certification: CCN 108114

Legal name
GULFT COAST VILLAGE HOME HEALTH
Doing business as
HOME HEALTH BY GULF COAST VILLAGE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 9, 2004
Last certification
Oct 30, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Mar 3, 2004 in FL
Enrollment address
1435 Santa Barbara Blvd
Ste 1
Cape Coral, FL 33991-2842

Care Compare: Home health agency

Medicare Care Compare
Listed as
Home Health by Gulf Coast VillageCCN 108114
Overall star rating
5 of 5
Ownership
Non-Profit
Certified
Nov 9, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory

Locations

1435 Santa Barbara Blvd
Ste 1
Cape Coral, FL 33991
Phone (239) 242-7198

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kevin W Ahmadi Individual Corporate Officer Sep 9, 2004
Corporate Director Aug 1, 2004
W-2 Managing Employee Sep 9, 2004
Dawn Baratta-Bayer Individual Corporate Director Sep 9, 2004

Practitioners & affiliated clinicians

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1215938535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 SANTA BARBARA BLVD STE 1",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912842",
            "telephone_number": "239-772-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 SANTA BARBARA BLVD STE 1",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912842",
            "telephone_number": "239-772-7480",
            "fax_number": "239-772-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST VILLAGE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "DIR. OF HOME & COMM BASED SERVICES",
        "authorized_official_telephone_number": "239-772-7480",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA29991969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Health by Gulf Coast Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.