Individual provider Active NPI

Julie Independence Tomchak, CNA/LNA/PCT

  • Nurse's Aide
  • Lakeland, FL
National Provider Identifier
1376189209
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
384331 Issued in FL
Practice address
7805 US Highway Lot 29 # 98 N
Lakeland, FL 33809
Phone
(603) 491-2415
NPI assigned
Nov 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CNA34744 MA
Nurse's Aide 376K00000X 384331 FL Primary
Nurse's Aide 376K00000X 000000009281MT ID
Nurse's Aide 376K00000X 046617-24 NH
Nurse's Aide 376K00000X 340591 MT

Addresses

Primary practice location

7805 US Highway Lot 29 # 98 N
Lakeland, FL 33809

Mailing address

7805 US Highway Lot 29 # 98 N
Lakeland, FL 33809
Phone (603) 491-2415

Other names 1

  • Mrs. Julie Independence Tomchak Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Fax Direct

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
384331FLMDNurse's Aide
000000009281MTIDMDNurse's Aide
CNA34744MAMDNurse's Aide
340591MTMDNurse's Aide
046617-24NHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1376189209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7805 US HIGHWAY LOT 29 # 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33809",
            "telephone_number": "603-491-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7805 US HIGHWAY LOT 29 # 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33809",
            "telephone_number": "603-491-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCHAK",
        "first_name": "JULIE",
        "middle_name": "INDEPENDENCE",
        "credential": "CNA/LNA/PCT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MA",
            "license": "CNA34744",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "384331",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "ID",
            "license": "000000009281MT",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NH",
            "license": "046617-24",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MT",
            "license": "340591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Anything necessary for Billing Requirements or  to Primary Care MD",
            "address_1": "7805 US Highway Lot 29 # 98 N",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "TOMCHAK",
            "middle_name": "INDEPENDENCE",
            "prefix": "MRS.",
            "credential": "BAXTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.