Active NPI
Ishmael Bougouneau
- Home Health Agency
- Orlando, FL
National Provider Identifier
1467998930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 2059 Veranda Cir BLDG J
Orlando, FL 32808-4861 - Phone
- (321) 914-7628
- NPI assigned
- Jan 9, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Home Health Agency | 251E00000X | FL | Primary | |
| In Home Supportive Care Agency | 253Z00000X | FL | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | FL | ||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X |
Addresses
Primary practice location
2059 Veranda Cir BLDG J
Orlando, FL 32808-4861
Mailing address
2059 Veranda Cir BLDG J
Orlando, FL 32808-4861
Phone (321) 914-7628
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1467998930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2059 VERANDA CIR BLDG J",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328084861",
"telephone_number": "321-914-7628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2059 VERANDA CIR BLDG J",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328084861",
"telephone_number": "321-914-7628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUGOUNEAU",
"first_name": "ISHMAEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-09",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.