Jillian L Ricard

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

CBC035798 Issued in FL

Practice address

926 SE Belfast Avenue
Port Saint Lucie, FL 34983-3498

Phone

(772) 924-5773

Fax

(772) 924-5773

NPI assigned

Oct 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Contractors Group

  • Case Manager/Care Coordinator
  • Port Saint Lucie, FL
  • NPI 1053823252
  NPD Authorized official

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1366953952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 SE BELFAST AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349833914",
            "telephone_number": "772-924-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 SE BELFAST AVENUE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349833498",
            "telephone_number": "772-924-5773",
            "fax_number": "772-924-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICARD",
        "first_name": "JILLIAN",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "FL",
            "license": "CBC035798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED BUILDING CONTRACTOR",
            "identifier": "CBC035798",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Michelle Reynolds, RBT
• Stephanie Michelle Reynolds, M.S.
• Susan Reynolds
• Rez Med Medical Supply LLC
• Reza Ardalan DMD PA
• Richard Cruz Capital LLC
• Richard J Pena- Ariet MD PA
• Alicia Richardson
• Lorna D Richardson
• Zeobia Sherease Richardson

• Home Modifications Contractor in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Home Modifications Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.