Ccmedic Homecare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CCMEDIC HOMECARE LLC

Practice address

7320 E Fletcher Ave Ste 155
Tampa, FL 33637-0916

Phone

(816) 944-2243

NPI assigned

Mar 21, 2023

Organization subpart

No

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

Authorized official

Name

Idongesit E Joseph, RN

Title

Registered Nurse

Phone

(813) 616-0446

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Home health agency certification: CCN 687334

Legal name

CCMEDIC HOMECARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 20, 2024

Last certification

Jun 11, 2024

Organization structure

LLCProprietary

Incorporated

Oct 19, 2021 in FL

Enrollment address

7320 E Fletcher Ave
Ste 155
Tampa, FL 33637-0916
HHA Branch

Listed as

Ccmedic Homecare LLCCCN 687334

Ownership

-

Certified

Jun 20, 2024

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Idongesit Edet

  • Registered Nurse
  • Riverview, FL
  • NPI 1922411388
  NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Agnes Ubani, MD

  • Family Medicine Physician
  • Temple Terrace, FL
  • NPI 1285702894

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1376245381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 E FLETCHER AVE STE 155",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336370916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 E FLETCHER AVE STE 155",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336370916",
            "telephone_number": "816-944-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCMEDIC HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "IDONGESIT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "813-616-0446",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Alan Cazabon, CRNA
• Elliot Cazes, M.D.
• Cba Pharmacy Inc
• Cba Pharmacy Inc
• CBS Labs of Tampa LLC
• CDB Services USA LLC
• Shannon Melissa Cea, APRN
• Daena Ceballo
• Sara Winna Ceballos
• Sergio Roberto Ceballos, LMT

• Home Health Agency in Tampa, FL
• Providers in Tampa, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.