The Wallis Agency, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

21282296 Issued in FL

Legal business name

THE WALLIS AGENCY, INC.

Doing business as

Onyx Home Care

Practice address

1184 Pelican Bay Dr
Daytona Beach, FL 32119-1381

Phone

(386) 676-1118

Fax

(866) 571-9365

NPI assigned

May 5, 2006

Last updated

Nov 25, 2016By 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

Colleen Margaret McGrew, R.N., B.S.N.

Title

President/Administrator

Phone

(386) 676-1118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Onyx Home Care Doing business as

Locations

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480032000000",
    "number": "1508814088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 PELICAN BAY DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321191381",
            "telephone_number": "386-676-1118",
            "fax_number": "866-571-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 PELICAN BAY DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321191381",
            "telephone_number": "386-676-1118",
            "fax_number": "866-571-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WALLIS AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-11-25",
        "status": "A",
        "authorized_official_last_name": "MCGREW",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "386-676-1118",
        "authorized_official_credential": "R.N., B.S.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "21282296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE #",
            "identifier": "21280096",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Onyx Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Daytona Beach, FL
• Providers in Daytona Beach, 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 Nov 25, 2016; 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.