Esp Case Management Professional, Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

ESP CASE MANAGEMENT PROFESSIONAL, INC

Practice address

687 Beville Rd Ste a
South Daytona, FL 32119-1970

Phone

(386) 760-7533

Fax

(386) 761-5868

NPI assigned

Oct 15, 2021

Organization subpart

No

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

Authorized official

Name

Mary L Fagaragan

Title

President

Phone

(386) 760-7533

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Esp Case Management Professional Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Esp Case Management Professional, Inc

  • Case Management Agency
  • South Daytona, FL
  • NPI 1033888441
  NPD tax ID
• Esp Case Management Professional, Inc

  • Community/Behavioral Health Agency
  • South Daytona, FL
  • NPI 1609083476
  NPD tax ID

Locations

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1285397471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 BEVILLE RD STE A",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191970",
            "telephone_number": "386-760-7533",
            "fax_number": "386-761-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 BEVILLE RD STE A",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191970",
            "telephone_number": "386-760-7533",
            "fax_number": "386-761-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESP CASE MANAGEMENT PROFESSIONAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-15",
        "last_updated": "2023-10-10",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "FAGARAGAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-760-7533"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110146900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Wanda Gayle Ellison, LPTA
• Esp Case Management Professional, Inc
• Esp Case Management Professional, Inc
• Louise Marie Ethier, DOM, AP
• Eyerly Health and Wellness LLC
• Jeffrey M Eyerly, DC
• Fagan Associates, Inc

• Case Management Agency in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.