NPIMap

Organization Active NPI

Variety Children's Hospital

Doing business as Nicklaus Children's Hospital LifeFlight

  • Ambulance
  • Opa Locka, FL
National Provider Identifier
1255668331
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
3485 Issued in FL
Legal business name
VARIETY CHILDREN'S HOSPITAL
Doing business as
Nicklaus Children's Hospital LifeFlight
Practice address
15001 NW 42ND Ave
Opa Locka, FL 33054-2316
Phone
(305) 663-8533
Fax
(305) 669-6519
NPI assigned
Nov 10, 2009
Last updated
Jun 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Dawn Javersack, ADMINISTRATION
Title
SVP/Cfo
Phone
(786) 624-5747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 3485 FL Primary

Addresses

Primary practice location

15001 NW 42ND Ave
Opa Locka, FL 33054-2316

Mailing address

3100 SW 62ND Ave
Lifeflight
Miami, FL 33155-3009
Phone (786) 624-5837

Other names 1

  • Nicklaus Children's Hospital LifeFlight Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100325000559 FL Part B Supplier - Ambulance Service Supplier 0840200986 Practice locations: Miami, FL

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Variety Children's Hospital Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1255668331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "address_2": "LIFEFLIGHT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "786-624-5837",
            "fax_number": "305-669-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15001 NW 42ND AVE",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330542316",
            "telephone_number": "305-663-8533",
            "fax_number": "305-669-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARIETY CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "JAVERSACK",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "SVP/CFO",
        "authorized_official_telephone_number": "786-624-5747",
        "authorized_official_credential": "ADMINISTRATION"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "FL",
            "license": "3485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicklaus Children's Hospital LifeFlight",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Opa Locka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.