Care One Support LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

CARE ONE SUPPORT LLC

Practice address

2609 Navajo Ave
Fort Pierce, FL 34946-1729

Phone

(772) 519-6265

NPI assigned

Aug 30, 2018

Organization subpart

No

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

Authorized official

Name

Debra Ball

Title

Ceo

Phone

(772) 519-6265

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1518449206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 NAVAJO AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349461729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 NAVAJO AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349461729",
            "telephone_number": "772-519-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE ONE SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-519-6265"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Cannon, APRN, FNP-BC
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• Developmental Disabilities Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.