Suncrest Home Health of Tampa, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SUNCREST HOME HEALTH OF TAMPA, LLC

Doing business as

SunCrest OMNI

Practice address

311 Park Place Blvd Ste 120
Clearwater, FL 33759-4904

Phone

(727) 260-6680

Fax

(727) 441-8311

NPI assigned

Oct 11, 2019

Organization subpart

No

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

Authorized official

Name

Nicholas Gachassin III

Title

Executive Vice President

Phone

(337) 233-1307

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• SunCrest OMNI Doing business as

Locations

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1245872225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PARK PLACE BLVD STE 120",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594904",
            "telephone_number": "727-260-6680",
            "fax_number": "727-441-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCREST HOME HEALTH OF TAMPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104652000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunCrest OMNI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SunCrest OMNI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Clearwater, FL
• Providers in Clearwater, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.