Organization Active NPI

Traditional Medical Home Health Services

  • Home Health Agency
  • Winter Haven, FL
National Provider Identifier
1417067000
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TRADITIONAL MEDICAL HOME HEALTH SERVICES
Practice address
342 E Central Ave
Winter Haven, FL 33880-3046
Phone
(863) 512-2622
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert E Wolf, RN, BS, ACLS
Title
Administrator
Phone
(863) 512-2622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

342 E Central Ave
Winter Haven, FL 33880-3046

Mailing address

342 E Central Ave
Winter Haven, FL 33880-3046
Phone (863) 512-2622

National Provider Directory

National Provider Directory

Locations

342 E Central Ave
Winter Haven, FL 33880
Phone (863) 512-2622

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417067000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803046",
            "telephone_number": "863-512-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803046",
            "telephone_number": "863-512-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRADITIONAL MEDICAL HOME HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-512-2622",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, BS, ACLS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.