Coastal Nursecare of Florida, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

299991520 Issued in FL

Legal business name

COASTAL NURSECARE OF FLORIDA, INC.

Doing business as

Addus HomeCare

Practice address

2160 Creighton Rd
Pensacola, FL 32504-7218

Phone

(850) 475-9000

Fax

(850) 475-9330

NPI assigned

Sep 13, 2005

Last updated

Apr 30, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darby Anderson

Title

Evp Cgro

Phone

(630) 296-3443

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Addus HomeCare Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407841729. Details of each certification follow.

• CCN 10K008 Home health agency · Active · Name & address match · Details

Home health agency certification: CCN 10K008

Legal name

ADDUS HOMECARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 4, 2003

Last certification

Aug 1, 2019

Ownership / control type

Proprietary

Facility address

2160 Creighton Rd
Pensacola, FL 32504

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

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1407841729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WARRENVILLE RD STE 800",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605320912",
            "telephone_number": "850-475-9000",
            "fax_number": "850-475-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 CREIGHTON RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047218",
            "telephone_number": "850-475-9000",
            "fax_number": "850-475-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL NURSECARE OF FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DARBY",
        "authorized_official_title_or_position": "EVP CGRO",
        "authorized_official_telephone_number": "630-296-3443"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299991520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "JP4",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650996700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "685500800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "684119896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Addus HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Pensacola, FL
• Providers in Pensacola, 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 Apr 30, 2025; 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.