Individual provider Active NPI

Greg Farias

  • Home Health Registered Nurse
  • Coral Springs, FL
National Provider Identifier
1336665272
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN9336363 Issued in FL
Practice address
10251 W Sample Rd Ste D
Coral Springs, FL 33065-3928
Phone
(954) 507-4530
NPI assigned
Aug 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN9336363 FL Primary

Addresses

Primary practice location

10251 W Sample Rd Ste D
Coral Springs, FL 33065-3928

Mailing address

10251 W Sample Rd Ste D
Coral Springs, FL 33065-3928
Phone (954) 507-4530

Other identifiers 1

IdentifierTypeStateIssuer
299994695OtherFLFLORIDA AHCA

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

LicenseStateTypeSpecialty
RN9336363FLMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CG3 Enterprises Inc. CurrentSince Jul 24, 2022 Accepting new patients

Locations

10251 W Sample Rd
Ste D
Coral Springs, FL 33065
Phone (954) 507-4530

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336665272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10251 W SAMPLE RD STE D",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653928",
            "telephone_number": "954-507-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10251 W SAMPLE RD STE D",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653928",
            "telephone_number": "954-507-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIAS",
        "first_name": "GREG",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "FL",
            "license": "RN9336363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA AHCA",
            "identifier": "299994695",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.