NPIMap

Organization Active NPI

Nursecore Management Services, LLC

Doing business as Nursecore of Fort Myers

  • Home Health Agency
  • Fort Myers, FL
National Provider Identifier
1225075922
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA207820961 Issued in FL
Legal business name
NURSECORE MANAGEMENT SERVICES, LLC
Doing business as
Nursecore of Fort Myers
Practice address
4350 Fowler St
Suite 4
Fort Myers, FL 33901-2699
Phone
(239) 278-3633
Fax
(239) 278-4984
NPI assigned
Jun 1, 2006
Last updated
Apr 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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 HHA207820961 FL Primary

Addresses

Primary practice location

4350 Fowler St
Suite 4
Fort Myers, FL 33901-2699

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
H0YOtherFLBLUE CROSS BLUE SHIELD
650914200MedicaidFL

Other names 1

  • NURSECORE OF FORT MYERS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030807000031 TX Part A Provider - Home Health Agency 3476462391 Practice locations: Fort Myers, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225075922. Details of each certification follow.

Home health agency certification: CCN 107461

Legal name
NURSECORE MANAGEMENT SERVICES LLC
Doing business as
NURSECORE OF FORT MYERS
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 18, 1993
Last certification
May 23, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
May 9, 1996 in TX
Enrollment address
4350 Fowler Street
Suite 4
Fort Myers, FL 33901-2616

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Nursecore of Fort MyersCCN 107461 · All quality measures
Ownership
Proprietary
Certified
Jun 18, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
10D0725797Nursecore of Ft Myers4350 Fowler St Ste 4, Fort Myers, FL 33901Certificate of waiverAug 31, 2026

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

4350 Fowler St
Ste 4
Fort Myers, FL 33901
Phone (239) 278-3633

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Sharon Carr Individual 5% Or Greater Indirect Ownership Interest May 9, 1996 100%
Corporate OfficerOwner/Board Member May 9, 1996
Corporate DirectorOwner/Board Member May 9, 1996
W-2 Managing EmployeeOwner/Board Member May 9, 1996
Nursecore Management Services LLC Organization, Arlington, TX LLC 5% Or Greater Direct Ownership Interest May 9, 1996 100%
Kathryn Cole Kelley Individual Corporate OfficerCoo Oct 8, 2015
David T Guillory Individual Operational/Managerial ControlCorporate Compliance Director Jul 23, 2019
Deborah Y Lollar Individual Corporate OfficerPresident/Ceo Jun 16, 2008
Corporate DirectorPresident/Ceo Jun 16, 2008
Operational/Managerial ControlPresident/Ceo Jun 16, 2008

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1225075922",
    "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": "4350 FOWLER ST",
            "address_2": "SUITE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339012699",
            "telephone_number": "239-278-3633",
            "fax_number": "239-278-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSECORE MANAGEMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "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": "HHA207820961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "H0Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650914200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NURSECORE OF FORT MYERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.