Active NPI
Sandra Purk, ADMINISTRATOR
- Home Health Aide
- Brooksville, FL
National Provider Identifier
1265067201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 30212059
- Practice address
- 725 Desoto Ave
Brooksville, FL 34601-2813 - Phone
- (352) 405-1234
- Fax
- (352) 388-1924
- NPI assigned
- Mar 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 30212059 | FL | Primary |
Addresses
Primary practice location
725 Desoto Ave
Brooksville, FL 34601-2813
Mailing address
4344 Rachel Blvd
Spring Hill, FL 34607-2532
Phone (352) 405-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30212059 | FL | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1265067201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4344 RACHEL BLVD",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346072532",
"telephone_number": "352-405-1234",
"fax_number": "352-388-1924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 DESOTO AVE",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346012813",
"telephone_number": "352-405-1234",
"fax_number": "352-388-1924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURK",
"first_name": "SANDRA",
"credential": "ADMINISTRATOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-10",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "FL",
"license": "30212059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooksville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.